Components of alveolar-arterial O2 gradient during rest and exercise at sea level and high altitude

Abstract

To determine the effects of exercise and high altitude on the contributions of shunt, ventilation-perfusion (.ovrhdot.V/.ovrhdot.Q) nonhomogeneity and diffusion limitation to the alveolar-arterial O2 gradient (AaDO2), pulmonary exchange of O2, CO2 and 6 inert gases (SF6, ethane, cyclopropane, halothane, diethyl ether, and acetone) were measured during rest and exercise in unanesthetized dogs at sea level and after acute exposure to an altitude of 6096 m in a hypobaric chamber. Shunt and dead space fractions, calculated from inert gas measurements, did not change. High altitude decreased the inert gas partial pressure gradients between mixed alveolar gas and mixed end-capillary blood, indicating that .ovrhdot.V/.ovrhdot.Q relationships became more homogeneous. Exercise had no effect on these gradients. At sea level AaDO2 was mainly due to .ovrhdot.V/.ovrhdot.Q nonhomogeneity, with a small portion due to shunt. At high altitude the contribution of shunt became negligible and that of .ovrhdot.V/.ovrhdot.Q nonhomogeneity diminished. These improvements were partially offset by a gradient due to diffusion limitation. Exercise had no effect on AaDO2 or any of its components. At high altitude estimated pulmonary O2 diffusing capacity averaged 20.8 ml .cntdot. min-1 .cntdot. torr-1 at rest and 35.3 ml .cntdot. min-1 .cntdot. torr-1 during exercise.