头低位倾斜并施加下体负压时的眼内压和颅内压
Intraocular and intracranial pressures during head-down tilt with lower body negative pressure.
作者信息
Macias Brandon R, Liu John H K, Grande-Gutierrez Noelia, Hargens Alan R
机构信息
Departments of Orthopaedic Surgery and Ophthalmology, UCSD Medical Center, University of California, San Diego, CA, USA.
出版信息
Aerosp Med Hum Perform. 2015 Jan;86(1):3-7. doi: 10.3357/AMHP.4044.2015.
BACKGROUND
Seven astronauts after 6-mo missions to the International Space Station showed unexpected vision problems. Lumbar punctures performed in the four astronauts with optic disc edema showed moderate elevations of cerebral spinal fluid pressure after returning to Earth. We hypothesized that lower body negative pressure (LBNP) imposed during head-down tilt (HDT) would reduce intraocular pressure (IOP) and transcranial ultrasound pulse amplitude, a noninvasive intracranial pressure (ICP) surrogate.
METHODS
Participating in this study were 25 normal healthy nonsmoking volunteers (mean age: 36 yr). Subjects were positioned supine (5 min), sitting (5 min), 15° whole body HDT (5 min), and 10 min of HDT with LBNP (25 mmHg). The order of HDT and HDT+LBNP tests was balanced. Right and left IOP, transcranial ultrasound pulse amplitude, arm blood pressure, and heart rate were measured during the last minute (steady state) of each testing condition.
RESULTS
IOP significantly decreased from supine to sitting posture by 3.2 ± 1.4 mmHg (mean ± SD: N = 25), and increased by 0.9 ± 1.3 mmHg from supine to the HDT position. LBNP during HDT significantly lowered IOP to supine levels. In addition, LBNP significantly reduced transcranial ultrasound pulse amplitudes by 38% as compared to the HDT condition (N = 9). Sitting mean blood pressure (BP) was significantly higher (+5 mmHg) than BP values after 10 min of LBNP during HDT. However, heart rate was not significantly different across all conditions.
DISCUSSION
These data suggest that short duration exposures to LBNP attenuate HDT-induced increases in IOP and ICP. Macias BR, Liu JHK, Grande-Gutierrez N, Hargens AR. Intraocular and intracranial pressures during head-down tilt with lower body negative pressure.
背景
7名执行了为期6个月国际空间站任务的宇航员出现了意想不到的视力问题。对4名患有视盘水肿的宇航员进行的腰椎穿刺显示,他们返回地球后脑脊液压力中度升高。我们假设,在头低位倾斜(HDT)期间施加的下体负压(LBNP)会降低眼压(IOP)和经颅超声脉冲幅度,后者是一种无创颅内压(ICP)替代指标。
方法
25名正常健康的非吸烟志愿者(平均年龄:36岁)参与了本研究。受试者先仰卧(5分钟)、坐着(5分钟)、进行15°全身HDT(5分钟),然后进行10分钟的HDT并施加LBNP(25 mmHg)。HDT和HDT + LBNP测试的顺序是平衡的。在每个测试条件的最后一分钟(稳态)测量左右眼眼压、经颅超声脉冲幅度、手臂血压和心率。
结果
眼压从仰卧位到坐姿显著降低3.2±1.4 mmHg(平均值±标准差:N = 25),从仰卧位到HDT位升高0.9±1.3 mmHg。HDT期间施加LBNP可使眼压显著降至仰卧位水平。此外,与HDT条件相比,LBNP使经颅超声脉冲幅度显著降低38%(N = 9)。坐姿平均血压(BP)比HDT期间施加LBNP 10分钟后的BP值显著高(+5 mmHg)。然而,所有条件下心率无显著差异。
讨论
这些数据表明,短时间暴露于LBNP可减弱HDT引起的眼压和颅内压升高。马西亚斯BR、刘JHK、格兰德 - 古铁雷斯N、哈根斯AR。头低位倾斜下体负压时的眼内压和颅内压。