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Cerebral blood velocity regulation during progressive blood loss compared to lower body negative pressure in humans.

Cerebral blood velocity regulation during progressive blood loss compared to lower body negative pressure in humans.

J Appl Physiol (1985). 2015 Jul 2;:jap.00127.2015

Authors: Rickards CA, Johnson BD, Harvey RE, Convertino VA, Joyner MJ, Barnes JN

Abstract
Lower body negative pressure (LBNP) is often used to simulate blood loss in humans. It is unknown if cerebral blood flow responses to actual blood loss are analogous to simulated blood loss during LBNP. Nine healthy men were studied at baseline, during 3 levels of LBNP (5-min at -15, -30, -45 mmHg), and during 3 levels of blood loss (333, 667, 1000 ml). LBNP and blood loss conditions were randomized. Intra-arterial mean arterial pressure (MAP) was similar during LBNP compared with blood loss (p≥0.42). Central venous pressure (CVP; 2.8±0.7 vs. 4.0±0.8, 1.2±0.6 vs. 3.5±0.8, 0.2±0.9 vs. 2.1±0.9 mmHg for level 1, 2, and 3; p≤0.003) and stroke volume (71±4 vs. 80±3, 60±3 vs. 74±3, 51±2 vs. 68±4 ml for level 1, 2, and 3; p≤0.002) were lower during LBNP compared with blood loss. Despite differences in CVP, middle cerebral artery velocity (MCAv) and cerebrovascular conductance (CVC) were similar between LBNP and blood loss at each level (MCAv at level 3: 62±6 vs. 66±5 cm/s; p=0.37; CVC at level 3: 0.72±0.05 vs. 0.73±0.05 cm/s/mmHg; p=0.53). While the slope of the relationship between MAP and MCAv was slightly different between LBNP and blood loss (LBNP: 0.41 ±0.03 cm/s/mmHg vs. Blood Loss: 0.66 ± 0.04 cm/s/mmHg; P=0.05), time domain gain between MAP and MCAv at maximal LBNP/blood loss (P=0.23), and low frequency MAP-mean MCAv transfer function coherence, gain and phase were similar (P≥0.10). Our results suggest that cerebral hemodynamic responses to LBNP to -45 mmHg and blood loss up to 1000 ml follow a similar trajectory, and the relationship between arterial pressure and cerebral blood velocity are not altered from baseline under these conditions.

PMID: 26139213 [PubMed - as supplied by publisher]

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