BACKGROUND While the etiology of the Spaceflight Associated Neuro-ocular Syndrome (SANS) is currently unknown, headward fluid shifts due to the removal of all gravitational vectors in space is hypothesized to be a major contributing factor. A countermeasure (CM) that can successfully redistribute body fluids similar to the upright position on Earth may thus be important for the prevention of SANS. Our SPACE-CENT Study (Studying the Physiological and Anatomical Effects of Centrifugation and Head-Down Tilt) seeks to investigate the cerebral, ocular and vestibular effects of 60-day exposure to strict 6o head-down tilt bed rest as a spaceflight analog with and without daily centrifugation. METHODS This study is part of the ongoing AGBRESA study at the DLR :envihab facility. As one component of our SPACE-CENT project, near-infrared spectroscopy (NIRS) derived total hemoglobin concentrations ([HbT]) from 4 body locations (head, chest, thigh, and calf) was measured before, during and after the international-standard orthostatic tilt test: tilt from supine to +80o, maintain for 15 min, then increase lower-body negative pressure (LBNP) by +10 mmHg every 3 minutes until subjects exhibit pre-syncope signs via a simultaneous drop in blood pressure and heart rate. RESULTS As of October 2019, the entire protocol has been completed on n=12 subjects (4 females), 5 days before bed rest onset and on R+0 following 60 days of -6o HDT bed rest. Significant shifts in [HbT]—proportional to blood volume—were observed from the head towards the feet during tilt to +80o in all subjects (Figure 1). All subjects had tests terminated sooner on R+0 (462±346 sec) than on BDC-5 (1105±464 sec), although the inter-subject variability was large (range=125-1751 sec). Interestingly, a subset of subjects (n=3) exhibited an initial increase in cerebral [HbT] at the onset of +80o, whereas the remainder showed no change or a decrease in cerebral [HbT] following tilt onset, which was predictive of longer orthostatic trials (t=2.46, p=0.022). All subjects exhibited an accelerating decrease in cerebral [HbT] that preceded test termination by 59±54 sec. CONCLUSIONS This represents preliminary findings from the first campaign of the study (12 of a planned 24 subjects). As such, final conclusions are not yet possible. However, the consistency of findings across subjects suggests that NIRS-based measures of fluid shifts along the body axis—and particularly out of the head—can predict the onset of pre-syncope by up to nearly a minute. Such data could be combined with the simultaneously acquired European Space Agency measurements of blood pressure to improve predictions of orthostatic tolerance.
PHYSIOLOGICAL MONITORING OF FLUID SHIFTS DURING ORTHOSTATIC TILT
2020 ; Galveston
2020
Aufsatz (Konferenz)
Elektronische Ressource
Englisch
NTRS | 1997
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