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Wade, C. E.

Publications and source records attributed to Wade, C. E..

49 records · Page 3

Effect of hemorrhage on cardiac output, vasopressin, aldosterone, and diuresis during immersion in men

The purpose of this research was to test the hypotesis that a reduction in blood volume would attenuate or eliminate immersion-induced increases in cardiac output (Q(sub co)) and urine excretion, and to investigate accompanying vasoactive and fluid-electrolyte hormonal responses. Eight men (19-23 yr) were supine during a 2-hr control period in air, and then sat for 5-hr test periods in air at 20 C (dry control, DC); water at 34.5 C (wet control, WC); and water (34.5 C) after hemorrhage (WH) of 14.8 plus or minus 0.3 percent of their blood volume. Blood volume was -11.6 plus or minus 0.6 percent at immersion (time 0). Mean (bar-X hrs 1-5) Q(sub co) was unchanged in WC (5.3 plus or minus 0.01 l/min) and in WH (4.5 plus or minus 0.1 l/min), but decreased (P less than 0.05) in DC to 3.6 plus or minus 0.1 l/min. Mean urine excretion rates were 1.0 plus or minus 0.2 ml/min for DC and 1.1 plus or minus 0.2 ml/min for WH; both were lower (P less than 0.05) than that for WC of 2.0 plus or minus 0.4 ml/min. Plasma (Na+) and (Osm) were unchanged in all experiments. Mean plasma vasopressin (PVP) (bar-X hrs 1-5) was 1.1 plus or minus 0.1 pg/ml in WC, and higher (P less than 0.05) in DC (2.1 plus or minus 0.2 pg/ml)and WH (2.1 plus or minus 0.1 pg/ml); it was unchanged during air and water test periods. Thus, hemorrhage attenuated the immersion-induced increase in Q(sub co), eliminated the WC diuresis, maintained plasma renin activity and PVP at DC levels and did not change immersion-induced aldosterone suppression; the osmotic diuresis during control immersion is apparently not due to either aldosterone suppression or vasopressin suppression.

Greenleaf, J. E.↗

Periodic upright posture negates the suppression of neuroendocrine response to head down bedrest

Head down bedrest (HDT) decreases plasma neurohormone levels, attaining a nadir within four hours. The present study evaluates the effect of periodic standing or exercises (+G(z)) on this acute suppression of plasma neurohormones. Methods: Nine male subjects (mean plus or minus SE age 37 plus or minus 2 yr; height 182 plus or minus 2 cm; weight 83 plus or minus 3 kg) were admitted to the Human Research Facility on three occasions separated by one month. Subjects were assigned to head down tilt (minus 6 degrees) or 15-minutes of standing or moderate exercise at the end of each hour. Initially during an ambulatory period, subjects were placed in a supine position for 45-min and a control blood sample obtained. The next day following 4 hours of HDT with or without standing or exercise a blood sample was taken 45-min (3 3/4 hours into HDT) after the preceding stand or exercise. Blood was withdrawn and all plasma samples frozen for determination of neurohormone levels within the same assay. Plasma aldosterone, Plasma Renin Activity (PRA) vasopressin (AVP) and cortisol levels were measured by radioimmunoassay. Norepinephrine (NE) and epinephrine (E) levels were measured by electrochemical detection following HPLC. Values were compared by ANOVA, P less than 0.05. Results: Control levels following 45-min supine were not different between treatments. HDT suppressed plasma aldosterone (13.9 plus or minus 3.7 to 6.6 plus or minus 0.7 ng/dl) and NE levels (299 plus or minus 35 to 217 plus or minus 23 pg/dl), E (69 plus or minus 15 to 65 plus or minus 21 pg/ml), and PRA (0.64 plus or minus 0.13 to 0.58 plus or minus 0.17 ngAl/m/hr) were not significantly altered. Standing or exercise negated the decrease in aldosterone and NE levels due to HDT. Conclusions: Periodic upright posture (+G(z)) with or without exercise for 15-min out of each hour negates the acute suppression of aldosterone and NE associated with HDT.

Wade, C. E.↗

The value of the 4-day headdown bedrest model for screening countermeasures

In order to evaluate the benefits of periodic exposure to the +G(z) vector as a countermeasure to the physiological responses to minus 6 degree head down bedrest (HDT), we considered a two-tiered approach: (a) to use 4 days HDT as a quick and inexpensive means of screening countermeasures, (b) to use a 60 day HDT to validate the most promising candidates. The approach and results of a 4 day study are described here. Methods: Nine males were admitted to our Human Research Facility for one ambulatory control day followed by 4 days HDT and were released on the next day after completion of a peak oxygen consumption test (VO(sub 2 peak)). A battery of tests was selected and standardized to evaluate the known early effects of HDT on plasma volume, early bone markers, orthostatic tolerance, physical performance, and fluid and electrolytes and their hormone regulation. Fluid sodium (Na) and potassium (K) intake and output in the urine were monitored throughout. Plasma volume was determined with a modified Evans Blue method and orthostatic tolerance with a 60 degree head-up tilt test for 30 minutes - both of which were determined on the ambulatory control day and on day 4 of HDT. Immediately after completion of the tilt test subjects were returned to the minus 6 degree position until the next morning when a VO(sub 2 peak) (horizontal ergometer) was done. This was compared to a similar control test determined on 2 separate occasions before subject admission. Results: Four hours after going HDT produced significant decreases (p less than 0.05) in the circulating concentration of fluid and electrolyte regulating hormones. Plasma volume, orthostatic tolerance and VO(sub 2 peak) changed significantly after 4 days HDT. There was also the expected natriuresis on day 1 of HDT but no significant diuresis. The consistency of the pre-bedrest VO(sub 2 peak) tilt tests and plasma volumes was remarkable. Conclusions: The 4 day HDT model seems highly promising for screening a variety of countermeasures alone and in combination before validating their benefits in extended bedrest or flight experiments.

Vernikos, J.↗

Effect of leg exercise training on vascular volumes during 30 days of 6 deg head-down bed rest

In order to investigate the effects of leg exercise training on vascular volumes during 30 d of 6-deg head-down bed rest, plasma and red cell volumes, body density, and water balance were measured in 19 men confined to bed rest (BR). One group had no exercise training (NOE), another near-maximal variable-intensity isotonic exercise (ITE) for 60 min/d, and the third near-maximal intermittent isokinetic exercise (IKE) for 60 min/d. Mean energy costs for the NOE, IKE, and ITE regimens were determined. Body densities within groups and mean urine volumes between groups were unchanged during BR. Changes in red cell volume followed changes in plasma volume. There was close coupling between resting plasma volume and plasma protein and osmotic content. It is argued that the ITE training protocol is better than the IKE protocol for maintaining plasma volume during prolonged exposure to BR.

Greenleaf, J. E.↗

Effect of leg exercise training on vascular volumes during 30 days of 6 degrees head-down bed rest

Plasma and red cell volumes, body density, and water balance were measured in 19 men (32-42 yr) confined to bed rest (BR). One group (n = 5) had no exercise training (NOE), another near-maximal variable-intensity isotonic exercise for 60 min/day (ITE; n = 7), and the third near-maximal intermittent isokinetic exercise for 60 min/day (IKE; n = 7). Caloric intake was 2,678-2,840 kcal/day; mean body weight (n = 19) decreased by 0.58 +/- 0.35 (SE) kg during BR due to a negative fluid balance (diuresis) on day 1. Mean energy costs for the NOE, and IKE, and ITE regimens were 83 (3.6 +/- 0.2 ml O2.min-1.kg-1), 214 (8.9 +/- 0.5 ml.min-1.kg-1), and 446 kcal/h (18.8 +/- 1.6 ml.min-1.kg-1), respectively. Body densities within groups and mean urine volumes (1,752-1,846 ml/day) between groups were unchanged during BR. Resting changes in plasma volume (ml/kg) after BR were -1.5 +/- 2.3% (NS) in ITE, -14.7 +/- 2.8% (P less than 0.05) in NOE, and -16.8 +/- 2.9% (P less than 0.05) in IKE, and mean water balances during BR were +295, -106, and +169 ml/24 h, respectively. Changes in red cell volume followed changes in plasma volume. The significant chronic decreases in plasma volume in the IKE and NOE groups and its maintenance in the ITE group could not be accounted for by water balance or by responses of the plasma osmotic, protein, vasopressin, or aldosterone concentrations or plasma renin activity. There was close coupling between resting plasma volume and plasma protein and osmotic content.(ABSTRACT TRUNCATED AT 250 WORDS).

NASA Discipline Regulatory Physiology↗

The effects of 7.5% NaCl/6% dextran 70 on coagulation and platelet aggregation in humans

The combination solution of 7.5% NaCl/6% dextran 70 (HSD) administered IV gives hemodynamic improvement in the treatment of hemorrhagic hypotension. Since earlier dextran solutions were reported to interfere with blood coagulation, the effects of HSD on the prothrombin time (PT), the activated partial thromboplastin time (APTT), platelet aggregation, and platelet concentration were studied. The HSD mixed with human plasma (1:5 and 1:10) slightly prolonged PT, but had no effect on the APTT, compared with saline controls. The HSD also decreased human platelet aggregation at the 1:5 dilution. In separate mixing studies, the hypertonic saline component of HSD was associated with the prolongation of PT and decreased platelet aggregation. The data from these studies indicate that at its proposed therapeutic dose, HSD is expected to have minimal effect on blood coagulation.

NASA Center ARC↗

Neuroendocrine abnormalities in patients with traumatic brain injury

This article provides an overview of hypothalamic and pituitary alterations in brain trauma, including the incidence of hypothalamic-pituitary damage, injury mechanisms, features of the hypothalamic-pituitary defects, and major hypothalamic-pituitary disturbances in brain trauma. While hypothalamic-pituitary lesions have been commonly described at postmortem examination, only a limited number of clinical cases of traumatic hypothalamic-pituitary dysfunction have been reported, probably because head injury of sufficient severity to cause hypothalamic and pituitary damage usually leads to early death. With the improvement in rescue measures, an increasing number of severely head-injured patients with hypothalamic-pituitary dysfunction will survive to be seen by clinicians. Patterns of endocrine abnormalities following brain trauma vary depending on whether the injury site is in the hypothalamus, the anterior or posterior pituitary, or the upper or lower portion of the pituitary stalk. Injury predominantly to the hypothalamus can produce dissociated ACTH-cortisol levels with no response to insulin-induced hypoglycemia and a limited or failed metopirone test, hypothyroxinemia with a preserved thyroid-stimulating hormone response to thyrotropin-releasing hormone, low gonadotropin levels with a normal response to gonadotropin-releasing hormone, a variable growth hormone (GH) level with a paradoxical rise in GH after glucose loading, hyperprolactinemia, the syndrome of inappropriate ADH secretion (SIADH), temporary or permanent diabetes insipidus (DI), disturbed glucose metabolism, and loss of body temperature control. Severe damage to the lower pituitary stalk or anterior lobe can cause low basal levels of all anterior pituitary hormones and eliminate responses to their releasing factors. Only a few cases showed typical features of hypothalamic or pituitary dysfunction. Most severe injuries are sufficient to damage both structures and produce a mixed endocrine picture. Increased intracranial pressure, which releases vasopressin by altering normal hypothalamic anatomy, may represent a unique type of stress to neuroendocrine systems and may contribute to adrenal secretion by a mechanism that requires intact brainstem function. Endocrine function should be monitored in brain-injured patients with basilar skull fractures and protracted posttraumatic amnesia, and patients with SIADH or DI should be closely monitored for other endocrine abnormalities.

NASA Program Space Physiology and Countermeasures↗

Work capacity during 30 days of bed rest with isotonic and isokinetic exercise training

Results are presented from a study to determine whether or not short-term variable intensity isotonic and intermittent high-intensity isokinetic short-duration leg exercise is effective for the maintenance of peak O2 (VO2) uptake and muscular strength and endurance, respectively, during 30 days of -6 deg head-down bed rest deconditioning. The results show no significant changes in leg peak torque, leg mean total work, arm total peak torque, or arm mean total work for members of the isotonic, isokinetic, and controls groups. Changes are observed, however, in peak VO2 levels. The results suggest that near-peak variabile intensity, isotonic leg excercise maintains peak VO2 during 30 days of bed rest, while peak intermittent, isokinetic leg excercise protocol does not.

Greenleaf, J. E.↗

Orthostatic responses following 30-day bed rest deconditioning with isotonic and isokinetic exercise training

The effects of intensive exercise training on tilt tolerance following deconditioning of astronauts were investigated by studying orthostatic responses of 19 subjects who underwent two intensive exercise-training regimens during 30 days of -6-deg head-down bed rest (BR). Subjects were divided into no-exercise control group, and two exercise groups, one performing isotonic (Quinton ergometer) exercises, the other doing isokinetic (Lido ergometer) exercises. A 60-deg head-up tilt test was administered on the control day 1 and BR day 30; the test was terminated at 60 min or when presyncopal signs and/or symptoms occurred. It was found that exercise training did not affect tilt tolerance significantly.

Greenleaf, J. E.↗

Effect of antigravity suit inflation on cardiovascular, PRA, and PVP responses in humans

The effects of lower body and abdominal pressure, produced by antigravity suit inflation, on blood pressure, pulse rate, fluid and electrolyte shift, plasma vasopressin and plasma renin activity in humans in upright postures were studied. Five men and two women stood upright for 3 hr with the suit being either inflated or uninflated. In the control tests, the suit was inflated only during the latter part of the trials. Monitoring was carried out with a sphygnomanometer, with sensors for pulse rates, and using a photometer and osmometer to measure blood serum characteristics. The tests confirmed earlier findings that the anti-g suit eliminates increases in plasma renin activity. Also, the headward redistribution of blood obtained in the tests commends the anti-g suit as an alternative to water immersion or bed rest for initial weightlessness studies.

Kravik, S. E.↗

Inhibition of plasma vasopressin after drinking in dehydrated humans

The effects of nonosmotic and nonvolumetric factors on vasopressin secretion in dehydrated humans has been investigated experimentally, before and after drinking. The subjects of the experiment were five adult men and three adult women weighing 69-77 kg. In order to determine the influence of nonosmotic and nonvolumetric factors on vasopressin secretion, measurements were obtained of the following blood hematological indices: serum Na(+) content; serum K(+) content; osmolality; and hemoglobin. Measurements of hematocrit, plasma arginine vasopressin (AVP), aldosterone, and renin activity were also obtained. It is found that dehydration increased mean serum Na(+) content, osmolality,and AVP. No significant changes were observed in renin activity, hemoglobin, hematocrit, or plasma volume, while plasma aldosterone increased from 11.1 ng/dl after dehydration to 15.6 ng/dl between 30 and 60 min after drinking. A rapid fall of AVP content following rehydration occurred in the absence of changes in the primary regulators of AVP osmolality and plasma volume, with no change in blood pressure. On the basis of the experimental results, it is suggested that oropharyngeal factors may be the mechanism, for the observed decrease in AVP following rehydration.

Geelen, G.↗