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Effect of skin surface cooling on central venous pressure during orthostatic challenge.
Am J Physiol Heart Circ Physiol. 2005 Dec; 289(6):H2429-33.AJ

Abstract

Orthostatic stress leads to a reduction in central venous pressure (CVP), which is an index of cardiac preload. Skin surface cooling has been shown to improve orthostatic tolerance, although the mechanism resulting in this outcome is unclear. One possible mechanism may be that skin surface cooling attenuates the drop in CVP during an orthostatic challenge, thereby preserving cardiac filling. To test this hypothesis, CVP, arterial blood pressure, heart rate, and skin blood flow, as well as skin and sublingual temperatures, were recorded in nine healthy subjects during lower body negative pressure (LBNP) in both normothermic and skin surface cooling conditions. Cardiac output was also measured via acetylene rebreathing. Progressive LBNP was applied at -10, -15, -20, and -40 mmHg at 5 min/stage. Before LBNP, skin surface cooling lowered mean skin temperature, increased CVP, and increased mean arterial blood pressure (all P < 0.001) but did not change mean heart rate (P = 0.38). Compared with normothermic conditions, arterial blood pressure remained elevated throughout progressive LBNP. Although progressive LBNP decreased CVP under both thermal conditions, during cooling CVP at each stage of LBNP was significantly greater relative to normothermia. Moreover, at higher levels of LBNP with skin cooling, stroke volume was significantly greater relative to normothermic conditions. These data indicate that skin surface cooling induced an upward shift in CVP throughout LBNP, which may be a key factor for preserving preload, stroke volume, and blood pressure and improving orthostatic tolerance.

Authors+Show Affiliations

Inst. for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas, 7232 Greenville Ave., Dallas, TX 75231, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

16024573

Citation

Cui, Jian, et al. "Effect of Skin Surface Cooling On Central Venous Pressure During Orthostatic Challenge." American Journal of Physiology. Heart and Circulatory Physiology, vol. 289, no. 6, 2005, pp. H2429-33.
Cui J, Durand S, Levine BD, et al. Effect of skin surface cooling on central venous pressure during orthostatic challenge. Am J Physiol Heart Circ Physiol. 2005;289(6):H2429-33.
Cui, J., Durand, S., Levine, B. D., & Crandall, C. G. (2005). Effect of skin surface cooling on central venous pressure during orthostatic challenge. American Journal of Physiology. Heart and Circulatory Physiology, 289(6), H2429-33.
Cui J, et al. Effect of Skin Surface Cooling On Central Venous Pressure During Orthostatic Challenge. Am J Physiol Heart Circ Physiol. 2005;289(6):H2429-33. PubMed PMID: 16024573.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of skin surface cooling on central venous pressure during orthostatic challenge. AU - Cui,Jian, AU - Durand,Sylvain, AU - Levine,Benjamin D, AU - Crandall,Craig G, Y1 - 2005/07/15/ PY - 2005/7/19/pubmed PY - 2006/1/13/medline PY - 2005/7/19/entrez SP - H2429 EP - 33 JF - American journal of physiology. Heart and circulatory physiology JO - Am. J. Physiol. Heart Circ. Physiol. VL - 289 IS - 6 N2 - Orthostatic stress leads to a reduction in central venous pressure (CVP), which is an index of cardiac preload. Skin surface cooling has been shown to improve orthostatic tolerance, although the mechanism resulting in this outcome is unclear. One possible mechanism may be that skin surface cooling attenuates the drop in CVP during an orthostatic challenge, thereby preserving cardiac filling. To test this hypothesis, CVP, arterial blood pressure, heart rate, and skin blood flow, as well as skin and sublingual temperatures, were recorded in nine healthy subjects during lower body negative pressure (LBNP) in both normothermic and skin surface cooling conditions. Cardiac output was also measured via acetylene rebreathing. Progressive LBNP was applied at -10, -15, -20, and -40 mmHg at 5 min/stage. Before LBNP, skin surface cooling lowered mean skin temperature, increased CVP, and increased mean arterial blood pressure (all P < 0.001) but did not change mean heart rate (P = 0.38). Compared with normothermic conditions, arterial blood pressure remained elevated throughout progressive LBNP. Although progressive LBNP decreased CVP under both thermal conditions, during cooling CVP at each stage of LBNP was significantly greater relative to normothermia. Moreover, at higher levels of LBNP with skin cooling, stroke volume was significantly greater relative to normothermic conditions. These data indicate that skin surface cooling induced an upward shift in CVP throughout LBNP, which may be a key factor for preserving preload, stroke volume, and blood pressure and improving orthostatic tolerance. SN - 0363-6135 UR - https://www.unboundmedicine.com/medline/citation/16024573/Effect_of_skin_surface_cooling_on_central_venous_pressure_during_orthostatic_challenge_ L2 - http://www.physiology.org/doi/full/10.1152/ajpheart.00383.2005?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -