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On the other hand, the adaptability of pulmonary system structures to habitual physical training is substantially less than are other links in the O<jats:sub>2<\/jats:sub>transport system. Accordingly, in some highly fit, and even in some not sofit habitually active individuals, the lung's diffusion suiface, airways, and\/or chest-wall musculature are underbuilt relative to the demand for maximal O<jats:sub>2<\/jats:sub>transport. Two specific pulmonary limitations to exercise performance are proposed: (1) exercise-induced arterial hypoxemia secondary to excessive widening of the alveolar to arterial O<jats:sub>2<\/jats:sub>difference, inadequate hyperventilation, and metabolic acidosis; and (2) highly fatiguing levels of respiratory muscle work which effectively steals blood flow from locomotor muscles via sympathetically mediated reflexes and heightens the perception of limb discomfort and dyspnea. In this brief review, we describe the characteristics and causes of each of these proposed pulmonary limitations and their consequences to maximal O<jats:sub>2<\/jats:sub>uptake and exercise performance.<\/jats:p>","DOI":"10.1139\/h2003-066","type":"journal-article","created":{"date-parts":[[2012,12,14]],"date-time":"2012-12-14T14:05:35Z","timestamp":1355493935000},"page":"S2-S24","source":"Crossref","is-referenced-by-count":24,"title":["[The John Sutton Lecture: CSEP, 2002] Pulmonary System Limitations to Exercise in Health"],"prefix":"10.1139","volume":"28","author":[{"given":"Jerome A.","family":"Dempsey","sequence":"first","affiliation":[{"name":"Dept. of Population Health Sciences, John Rankin Laboratory of Pulmonary Medicine, University of Wisconsin\u2013Madison, Madison, WI 53705, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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