Suyama Joe, McEntire Serina J, Rittenberger Jon C, Rosalky Deena, Reis Steven E, Hostler David
Prehosp Emerg Care. 2016;20(2):283-91. doi: 10.3109/10903127.2015.1076092. Epub 2015 Nov 3.
In many operational scenarios, hypohydration can be corrected with oral rehydration following the work interval. Although rare, there are potential situations that require extended intervals of uncompensable heat stress exposure while working in personal protective equipment (PPE). Under these conditions, retention of body water may be valuable to preserve work capacity and reduce cardiovascular strain. We conducted a pilot study comparing intramuscular atropine sulfate versus saline placebo to establish the safety profile of the protocol and to provide pilot data for future investigations. Five, healthy, heat-acclimated subjects completed this crossover design laboratory study. Each subject performed up to one hour of exertion in a hot environment while wearing a chemical resistant coverall. Atropine sulfate (0.02 mg/kg) or an equivalent volume of sterile saline was administered by intramuscular injection. Core temperature, heart rate, perceptual measures, and changes in body mass were measured. All five subjects completed the acclimation period and both protocols. No adverse events occurred, and no pharmacologically induced delirium was identified. Change in body mass was less following exercise influenced by atropine sulfate (p = 0.002). Exertion time tended to be longer in the atropine sulfate arm (p = 0.08). Other measures appeared similar between groups. Intramuscular atropine sulfate reduced sweating and tended to increase the work interval under uncompensable heat stress when compared to saline placebo. Heart rate and temperature changes during exertion were similar in both conditions suggesting that the influence of an anticholinergic agent on thermoregulation may be minimal during uncompensable heat stress.
thermoregulation; cholinolytic; anticholinergic; reaction time.
在许多实际操作场景中，轻度脱水可在工作间隙通过口服补液来纠正。虽然罕见，但在穿着个人防护装备（PPE）工作时，存在需要长时间暴露于无法补偿的热应激环境的潜在情况。在这些条件下，保留体内水分对于维持工作能力和减轻心血管负担可能很有价值。我们进行了一项初步研究，比较硫酸阿托品肌肉注射与生理盐水安慰剂，以确定该方案的安全性，并为未来的研究提供初步数据。五名健康、热适应的受试者完成了这项交叉设计的实验室研究。每名受试者在炎热环境中穿着耐化学防护服进行长达一小时的运动。通过肌肉注射给予硫酸阿托品（0.02mg/kg）或等量的无菌生理盐水。测量核心体温、心率、感知指标和体重变化。所有五名受试者均完成了适应期和两种方案。未发生不良事件，也未发现药物引起的谵妄。硫酸阿托品影响的运动后体重变化较小（p = 0.002）。硫酸阿托品组的运动时间往往更长（p = 0.08）。两组之间的其他指标似乎相似。与生理盐水安慰剂相比，硫酸阿托品肌肉注射减少了出汗，并在无法补偿的热应激下倾向于延长工作间隔。两种情况下运动期间的心率和体温变化相似，这表明在无法补偿的热应激期间，抗胆碱能药物对体温调节的影响可能最小。
体温调节；胆碱能阻断剂；抗胆碱能；反应时间。
