Boussuges Alain
Naval Medical Institute (IMNSSA), Toulon, France.
Aviat Space Environ Med. 2006 Nov;77(11):1183-7.
Since thermoneutral head-out water immersion induces an increase in central blood volume and cardiac output along with a decrease in peripheral vascular resistance, we examined here whether thermoneutral immersion leads rapidly to an increase in arterial compliance.
Changes in hemodynamic status and arterial compliance induced by thermoneutral head-out water immersion to the midchest were studied in 26 healthy volunteers (15 women, 11 men) using a non-invasive pulse wave measurement system. Several hemodynamic parameters including stroke volume (SV) and large and small artery compliance were studied in a quiet room with a stable environmental temperature (25 degrees C) and during thermoneutral (34.5 degrees C) head-out water immersion.
In a preliminary study, an agreement between SV estimated by radial pulse contour analysis and that obtained by Doppler echocardiography was observed in ambient air. An increase in SV led to an increase in cardiac output (12%) 10 min after the start of immersion. Heart rate and arterial pressure remained unchanged. Systemic vascular resistance was significantly decreased and total arterial compliance estimated by the SV to aortic pulse pressure ratio was significantly increased. Radial pulse contour analysis confirmed these results with an increase in both large and small artery compliance.
In conclusion, radial pulse contour analysis provides an interesting method for assessing hemodynamic changes under environmental constraints. Our results were consistent with a prompt increase in arterial compliance during acute water immersion.
由于热中性头露出水面的水浸会导致中心血容量和心输出量增加,同时外周血管阻力降低,我们在此研究热中性浸浴是否会迅速导致动脉顺应性增加。
使用无创脉搏波测量系统,对26名健康志愿者(15名女性,11名男性)进行热中性头露出水面的水浸至胸部中部所引起的血流动力学状态和动脉顺应性变化的研究。在环境温度稳定(25摄氏度)的安静房间以及热中性(34.5摄氏度)头露出水面的水浸期间,研究了包括每搏输出量(SV)以及大动脉和小动脉顺应性在内的多个血流动力学参数。
在一项初步研究中,观察到在环境空气中通过桡动脉脉搏轮廓分析估算的SV与通过多普勒超声心动图获得的SV之间具有一致性。浸浴开始10分钟后,SV增加导致心输出量增加(12%)。心率和动脉压保持不变。全身血管阻力显著降低,通过SV与主动脉脉压之比估算的总动脉顺应性显著增加。桡动脉脉搏轮廓分析证实了这些结果,即大动脉和小动脉顺应性均增加。
总之,桡动脉脉搏轮廓分析为评估环境限制下的血流动力学变化提供了一种有趣的方法。我们的结果与急性水浸期间动脉顺应性迅速增加一致。