Central circulation during exercise after venesection and reinfusion of red blood cells.

To study central circulation at different levels of hemoglobin (Hb) concentration, five subjects performed submaximal and maximal exercise in three different situations: 1) control, 2) after venesection of 800 ml of whole blood, and 3) after reinfusion of the red blood cells about 30-35 days after venesection. Maximal oxygen uptake (VO2 max) decreased from 4.27 l-min-1) at control to 4.03 l-min-1 after venesection (P less than 0.05) and increased to 4.61 l-min-1 after reinfusion (P less than 0.05). Maximal values on cardiac output (Q), heart rate (HR), and stroke volume (SV) were the same in the three situations. Thus, there was no compensatory increase in Qmax due to the lowered arterial oxygen content (Cao2) after venesection. An increase of the Cao2 (Hb concentration) and a lowering of the Cvo2 contributed equally to the increased VO2 max after reinfusion. At a given submaximal VO2, HR and blood lactates were increased at lowered Hb concentration and decreased at increased Hb concentration over control levels. Correlation coefficient for the change in Q in relation to the acute change in Hb concentration at a given submaximal VO2 was -0.49 (P less than 0.05).