Perko G, Tilgreen R, Secher N H
Department of Anaesthesia, Copenhagen Muscle Research Centre, Denmark.
Eur J Appl Physiol Occup Physiol. 1995;72(1-2):179-82. doi: 10.1007/BF00964135.
We have used regional electrical impedance at 2.5 and 100 kHz over nine body sections (two thoracic, one abdominal, two thigh, two around the knee, and two lower leg) in eight subjects to determine the volume indifference point defined as the level at which fluid volume remained constant independent of body position changes in space. Passive head-up tilt and tilt with activation of the venous muscle pump of the legs were performed in 10 degrees increments from 0 to 60 degrees over 6 min. The impedance changes in relation to 0 degree were similar for the two frequencies. Over the thorax it increased in proportion to the head-up tilt angle by a mean of 3.8 (range 1.9 to 9.3) omega (100 kHz) at 60 degrees (P < 0.05), while the abdominal impedance did not change significantly. Over the thigh it decreased with increasing head-up tilt angle by a mean maximum of -2.3 (range -9.4 to -0.4) omega and over the lower leg by a mean of -2.7 (range -6.0 to -0.8) omega. There were only marginal changes around the knee, mean -1.5 (range -2.3 to -0.2) omega (P < 0.05), and no change around the ankle indicating that little or no fluid was accumulated in these regions. Changes in impedance during passive and active head-up tilt did not differ significantly in any but one position: between the greater trochanter and the mid thigh, where during passive tilt it decreased by a mean of -4.8 (range -9.4 to -1.9) omega, and with activation of the venous pump by a mean of only -1.2 (range -1.9 to -0.4) omega (P < 0.05). These results indicated that the vascular volume indifference point was positioned between the navel and iliac crest both during the passive and active head-up tilts although during the passive tilt, apparently more fluid was accumulated in the vessels of the thigh.
我们在8名受试者的9个身体部位(两个胸部、一个腹部、两个大腿、两个膝盖周围和两个小腿)测量了2.5 kHz和100 kHz的局部电阻抗,以确定容量无差异点,该点定义为液体容量保持恒定、与空间中身体位置变化无关的水平。在6分钟内,以10度的增量从0度到60度进行被动头高位倾斜以及激活腿部静脉肌肉泵的倾斜操作。两个频率下相对于0度的电阻抗变化相似。在胸部,它在60度时随头高位倾斜角度增加,100 kHz时平均增加3.8(范围1.9至9.3)Ω(P<0.05),而腹部电阻抗无显著变化。在大腿,它随头高位倾斜角度增加而降低,平均最大降低-2.3(范围-9.4至-0.4)Ω,在小腿平均降低-2.7(范围-6.0至-0.8)Ω。膝盖周围仅有微小变化,平均-1.5(范围-2.3至-0.2)Ω(P<0.05),脚踝周围无变化,表明这些区域几乎没有或没有液体蓄积。被动和主动头高位倾斜期间的电阻抗变化,除了一个位置外,在其他任何位置均无显著差异:在大转子和大腿中部之间,被动倾斜时平均降低-4.8(范围-9.4至-1.9)Ω,激活静脉泵时平均仅降低-1.2(范围-1.9至-0.4)Ω(P<0.05)。这些结果表明,在被动和主动头高位倾斜期间,血管容量无差异点位于肚脐和髂嵴之间,尽管在被动倾斜期间,大腿血管中显然蓄积了更多液体。