title: Facial cooling and peripheral chemoreflex mechanisms in humans.
abstract: OBJECTIVE
  Reductions in arterial oxygen partial pressure activate the peripheral chemoreceptors which increase ventilation, and, after cessation of breathing, reduce heart rate. We tested the hypothesis that facial cooling facilitates these peripheral chemoreflex mechanisms.
  
  
  METHODS
  Chemoreflex control was assessed by the ventilatory response to hypoxia (10% O2 in N2) and the bradycardic response to voluntary end-expiratory apnoeas of maximal duration in 12 young, healthy subjects. We recorded minute ventilation, haemoglobin O2 saturation, RR interval (the time between two R waves of the QRS complex) and the standard deviation of the RR interval (SDNN), a marker of cardiac vagal activity throughout the study. Measurements were performed with the subject's face exposed to air flow at 23 and 4 degrees C.
  
  
  RESULTS
  Cold air decreased facial temperature by 11 degrees C (P < 0.0001) but did not affect minute ventilation during normoxia. However, facial cooling increased the ventilatory response to hypoxia (P < 0.05). The RR interval increased by 31 +/- 8% of the mean RR preceding the apnoea during the hypoxic apnoeas in the presence of cold air, compared to 17 +/- 5% of the mean RR preceding the apnoea in the absence of facial cooling (P < 0.05). This increase occurred despite identical apnoea durations and reductions in oxygen saturation. Finally, facial cooling increased SDNN during normoxia and hypoxia, as well as during the apnoeas performed in hypoxic conditions (all P < 0.05).
  
  
  CONCLUSIONS
  The larger ventilatory response to hypoxia suggests that facial cooling facilitates peripheral chemoreflex mechanisms in normal humans. Moreover, simultaneous diving reflex and peripheral chemoreflex activation enhances cardiac vagal activation, and favours further bradycardia upon cessation of breathing.
authors.affiliation: Department of Cardiology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. jfxa@skynet.be
authors.forename: J F
authors.initials: JF
authors.lastname: Argacha
authors.forename: O
authors.initials: O
authors.lastname: Xhaët
authors.forename: M
authors.initials: M
authors.lastname: Gujic
authors.forename: G
authors.initials: G
authors.lastname: De Boeck
authors.forename: C
authors.initials: C
authors.lastname: Dreyfuss
authors.forename: M
authors.initials: M
authors.lastname: Lamotte
authors.forename: D
authors.initials: D
authors.lastname: Adamopoulos
authors.forename: P
authors.initials: P
authors.lastname: van de Borne
mesh_terms: D000328:Adult; D001049:Apnea / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D001833:Body Temperature Regulation / Q000502:physiology; D001919:Bradycardia / Q000503:physiopathology; D002628:Chemoreceptor Cells / Q000502:physiology; D003080:Cold Temperature; D005145:Face / Q000294:innervation*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology; D008297:Male; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology; D010313:Partial Pressure; D012018:Reflex / Q000502:physiology*; D012881:Skin Temperature / Q000502:physiology; D055815:Young Adult
chemical_list: D010100:Oxygen