Cerebral blood flow and oxygenation at maximal exercise: the effect of clamping carbon dioxide

During exercise, as end-tidal carbon dioxide (P_ETCO2$P_{\text{E}{\text{T}}_{\text{C}{\text{O}}_2}}$) drops after the respiratory compensation point (RCP), so does cerebral blood flow velocity (CBFv) and cerebral oxygenation. This low-flow, low-oxygenation state may limit work capacity. We hypothesized that by preventing the fall in P_ETCO2$P_{\text{E}{\text{T}}_{\text{C}{\text{O}}_2}}$ at peak work capacity (W_max) with a newly designed high-flow, low-resistance rebreathing circuit, we would improve CBFv, cerebral oxygenation, and W_max. Ten cyclists performed two incremental exercise tests, one as control and one with P_ETCO2$P_{\text{E}{\text{T}}_{\text{C}{\text{O}}_2}}$ constant (clamped) after the RCP. We analyzed , middle cerebral artery CBFv, cerebral oxygenation, and cardiopulmonary measures. At W_max, when we clamped P_ETCO2$P_{\text{E}{\text{T}}_{\text{C}{\text{O}}_2}}$ (39.7 ± 5.2 mmHg vs. 29.6 ± 4.7 mmHg, P < 0.001), CBFv increased (92.6 ± 15.9 cm/s vs. 73.6 ± 12.5 cm/s, P < 0.001). However, cerebral oxygenation was unchanged (ΔTSI −21.3 ± 13.1% vs. −24.3 ± 8.1%, P = 0.33), and W_max decreased (380.9 ± 20.4 W vs. 405.7 ± 26.8 W, P < 0.001). At W_max, clamping P_ETCO2$P_{\text{E}{\text{T}}_{\text{C}{\text{O}}_2}}$ increases CBFv, but this does not appear to improve W_max.