title: Acute volume expansion attenuates hyperthermia-induced reductions in cerebral perfusion during simulated hemorrhage.
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.
authors.affiliation: Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital of Dallas, Dallas, Texas 75231, USA.
authors.forename: Zachary J
authors.initials: ZJ
authors.lastname: Schlader
authors.forename: Thomas
authors.initials: T
authors.lastname: Seifert
authors.forename: Thad E
authors.initials: TE
authors.lastname: Wilson
authors.forename: Morten
authors.initials: M
authors.lastname: Bundgaard-Nielsen
authors.forename: Niels H
authors.initials: NH
authors.lastname: Secher
authors.forename: Craig G
authors.initials: CG
authors.lastname: Crandall
mesh_terms: D000328:Adult; D062186:Arterial Pressure / Q000502:physiology; D001783:Blood Flow Velocity / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D006470:Hemorrhage / Q000503:physiopathology*; D006801:Humans; D006979:Hyperthermia, Induced; D008150:Lower Body Negative Pressure / Q000379:methods; D008297:Male; D020768:Middle Cerebral Artery / Q000502:physiology*; D013815:Thermodilution / Q000379:methods
keywords: brain blood flow; heat stress; lower-body negative pressure; volume infusion