Acute volume expansion attenuates hyperthermia-induced reductions in cerebral perfusion during simulated hemorrhage

Zachary J. Schlader, Thomas Seifert, Thad E. Wilson, Morten Bundgaard-Nielsen, Niels H. Secher, Craig G. Crandall

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Hyperthermia reduces the capacity to withstand a simulated hemorrhagic challenge, but volume loading preserves this capacity. This study tested the hypotheses that acute volume expansion during hyperthermia increases cerebral perfusion and attenuates reductions in cerebral perfusion during a simulated hemorrhagic challenge induced by lower- body negative pressure (LBNP). Eight healthy young male subjects underwent a supine baseline period (pre-LBNP), followed by 15- and 30-mmHg LBNP while normothermic, hyperthermic (increased pulmonary artery blood temperature ∼1.1°C), and following acute volume infusion while hyperthermic. Primary dependent variables were mean middle cerebral artery blood velocity (MCAvmean), serving as an index of cerebral perfusion; mean arterial pressure (MAP); and cardiac output (thermodilution). During baseline, hyperthermia reduced MCAvmean (P = 0.001) by 12 ± 9% relative to normothermia. Volume infusion while hyperthermic increased cardiac output by 2.8 ± 1.4 l/min (P < 0.001), but did not alter MCAvmean (P = 0.99) or MAP (P = 0.39) compared with hyperthermia alone. Relative to hyperthermia, at 30-mmHg LBNP acute volume infusion attenuated reductions (P < 0.001) in cardiac output (by 2.5 ± 0.9 l/min; P < 0.001), MAP (by 5 ± 6 mmHg; P = 0.004), and MCAvmean (by 12 ± 13%; P = 0.002). These data indicate that acute volume expansion does not reverse hyperthermia-induced reductions in cerebral perfusion pre-LBNP, but that it does attenuate reductions in cerebral perfusion during simulated hemorrhage in hyperthermic humans.

Original languageEnglish (US)
Pages (from-to)1730-1735
Number of pages6
JournalJournal of applied physiology
Volume114
Issue number12
DOIs
StatePublished - Jun 15 2013

Keywords

  • Brain blood flow
  • Heat stress
  • Lower-body negative pressure
  • Volume infusion

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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