下体负压可在头低位倾斜期间无创性地降低颅内压和颈内静脉横截面积。
Lower-body negative pressure decreases noninvasively measured intracranial pressure and internal jugular vein cross-sectional area during head-down tilt.
作者信息
Watkins William, Hargens Alan R, Seidl Shannon, Clary Erika Marie, Macias Brandon R
机构信息
Department of Orthopedic Surgery, Altman Clinical and Translational Research Institute, La Jolla, California; and.
Department of Orthopedic Surgery, Altman Clinical and Translational Research Institute, La Jolla, California; and
出版信息
J Appl Physiol (1985). 2017 Jul 1;123(1):260-266. doi: 10.1152/japplphysiol.00091.2017. Epub 2017 May 11.
Long-term spaceflight induces a near visual acuity change in ~50% of astronauts. In some crew members, postflight cerebrospinal fluid (CSF) opening pressures by lumbar puncture are as high as 20.9 mmHg; these members demonstrated optic disc edema. CSF communicates through the cochlear aqueduct to affect perilymphatic pressure and tympanic membrane motion. We hypothesized that 50 mmHg of lower-body negative pressure (LBNP) during 15° head-down tilt (HDT) would mitigate elevations in internal jugular vein cross-sectional area (IJV CSA) and intracranial pressure (ICP). Fifteen healthy adult volunteers were positioned in sitting (5 min), supine (5 min), 15° HDT (5 min), and 15° HDT with LBNP (10 min) postures for data collection. Evoked tympanic membrane displacements (TMD) quantified ICP noninvasively. IJV CSA was measured using standard ultrasound techniques. ICP and IJV CSA increased significantly from the seated upright to the 15° HDT posture ( < 0.05), and LBNP mitigated these increases. LBNP at 25 mmHg reduced ICP during HDT (TMD of 322.13 ± 419.17 nl) to 232.38 ± 445.85 nl, and at 50 mmHg ICP was reduced further to TMD of 199.76 ± 429.69 nl. In addition, 50 mmHg LBNP significantly reduced IJV CSA (1.50 ± 0.33 cm) during 15° HDT to 0.83 ± 0.42 cm LBNP counteracts the headward fluid shift elevation of ICP and IJV CSA experienced during microgravity as simulated by15° HDT. These data provide quantitative evidence that LBNP shifts cephalic fluid to the lower body, reducing IJV CSA and ICP. The current study provides new evidence that 25 or 50 mmHg of lower body negative pressure reduces jugular venous pooling and intracranial pressure during simulated microgravity. Therefore, spaceflight countermeasures that sequester fluid to the lower body may mitigate cephalic venous congestion and vision impairment.
长期太空飞行会导致约50%的宇航员近视力发生变化。在一些机组人员中,飞行后腰穿测得的脑脊液(CSF)开放压力高达20.9 mmHg;这些人员出现了视盘水肿。脑脊液通过蜗水管进行连通,从而影响外淋巴压力和鼓膜运动。我们假设,在15°头低位倾斜(HDT)期间施加50 mmHg的下体负压(LBNP)可减轻颈内静脉横截面积(IJV CSA)和颅内压(ICP)的升高。15名健康成年志愿者分别处于坐姿(5分钟)、仰卧位(5分钟)、15°HDT(5分钟)以及15°HDT加LBNP(10分钟)的姿势下进行数据收集。通过诱发鼓膜位移(TMD)对颅内压进行无创定量。使用标准超声技术测量颈内静脉横截面积。从坐姿直立到15°HDT姿势,颅内压和颈内静脉横截面积显著增加(<0.05),而LBNP减轻了这些增加。25 mmHg的LBNP使HDT期间的颅内压(TMD为322.13±419.17 nl)降至232.38±445.85 nl,50 mmHg时颅内压进一步降至TMD为199.76±429.69 nl。此外,50 mmHg的LBNP在15°HDT期间将颈内静脉横截面积(1.50±0.33 cm)显著降至0.83±0.42 cm。LBNP可抵消在15°HDT模拟微重力期间所经历的颅内压和颈内静脉横截面积因头部液体转移而升高的情况。这些数据提供了定量证据,表明LBNP将头部液体转移至下半身,从而减小了颈内静脉横截面积和颅内压。当前研究提供了新的证据,即25或50 mmHg的下体负压可在模拟微重力期间减少颈静脉血液淤积和颅内压。因此,将液体隔离至下半身的太空飞行对策可能会减轻头部静脉充血和视力损害。
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