Effects of experimental hypovolemia and pain on pre‐ejection period and pulse transit time in healthy volunteers
Abstract Trauma patients may suffer significant blood loss, and noninvasive methods to diagnose hypovolemia in these patients are needed. Physiologic effects of hypovolemia, aiming to maintain blood pressure, are largely mediated by increased sympathetic nervous activity. Trauma patients may however...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-06-01
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| Series: | Physiological Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.14814/phy2.15355 |
| _version_ | 1797392829470736384 |
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| author | Håvard Djupedal Torkjell Nøstdahl Jonny Hisdal Svein Aslak Landsverk Lars Øivind Høiseth |
| author_facet | Håvard Djupedal Torkjell Nøstdahl Jonny Hisdal Svein Aslak Landsverk Lars Øivind Høiseth |
| author_sort | Håvard Djupedal |
| collection | DOAJ |
| description | Abstract Trauma patients may suffer significant blood loss, and noninvasive methods to diagnose hypovolemia in these patients are needed. Physiologic effects of hypovolemia, aiming to maintain blood pressure, are largely mediated by increased sympathetic nervous activity. Trauma patients may however experience pain, which also increases sympathetic nervous activity, potentially confounding measures of hypovolemia. Elucidating the common and separate effects of the two stimuli on diagnostic methods is therefore important. Lower body negative pressure (LBNP) and cold pressor test (CPT) are experimental models of central hypovolemia and pain, respectively. In the present analysis, we explored the effects of LBNP and CPT on pre‐ejection period and pulse transit time, aiming to further elucidate the potential use of these variables in diagnosing hypovolemia in trauma patients. We exposed healthy volunteers to four experimental sequences with hypovolemia (LBNP 60 mmHg) or normovolemia (LBNP 0 mmHg) and pain (CPT) or no pain (sham) in a 2 × 2 fashion. We calculated pre‐ejection period and pulse transit time from ECG and ascending aortic blood velocity (suprasternal Doppler) and continuous noninvasive arterial pressure waveform (volume‐clamp method). Fourteen subjects were available for the current analyses. This experimental study found that pre‐ejection period increased with hypovolemia and remained unaltered with pain. Pulse transit time was reduced by pain and increased with hypovolemia. Thus, the direction of change in pulse transit time has the potential to distinguish hypovolemia and pain. |
| first_indexed | 2024-03-08T23:53:13Z |
| format | Article |
| id | doaj.art-dd74456818814975b7c8cc5c4651af94 |
| institution | Directory Open Access Journal |
| issn | 2051-817X |
| language | English |
| last_indexed | 2024-03-08T23:53:13Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Physiological Reports |
| spelling | doaj.art-dd74456818814975b7c8cc5c4651af942023-12-13T09:35:42ZengWileyPhysiological Reports2051-817X2022-06-011012n/an/a10.14814/phy2.15355Effects of experimental hypovolemia and pain on pre‐ejection period and pulse transit time in healthy volunteersHåvard Djupedal0Torkjell Nøstdahl1Jonny Hisdal2Svein Aslak Landsverk3Lars Øivind Høiseth4Department of Anesthesiology Telemark Hospital Skien NorwayDepartment of Anesthesiology Telemark Hospital Skien NorwayUniversity of Oslo Oslo NorwayDepartment of Anesthesiology and Intensive Care Oslo University Hospital Oslo NorwayDepartment of Anesthesiology and Intensive Care Oslo University Hospital Oslo NorwayAbstract Trauma patients may suffer significant blood loss, and noninvasive methods to diagnose hypovolemia in these patients are needed. Physiologic effects of hypovolemia, aiming to maintain blood pressure, are largely mediated by increased sympathetic nervous activity. Trauma patients may however experience pain, which also increases sympathetic nervous activity, potentially confounding measures of hypovolemia. Elucidating the common and separate effects of the two stimuli on diagnostic methods is therefore important. Lower body negative pressure (LBNP) and cold pressor test (CPT) are experimental models of central hypovolemia and pain, respectively. In the present analysis, we explored the effects of LBNP and CPT on pre‐ejection period and pulse transit time, aiming to further elucidate the potential use of these variables in diagnosing hypovolemia in trauma patients. We exposed healthy volunteers to four experimental sequences with hypovolemia (LBNP 60 mmHg) or normovolemia (LBNP 0 mmHg) and pain (CPT) or no pain (sham) in a 2 × 2 fashion. We calculated pre‐ejection period and pulse transit time from ECG and ascending aortic blood velocity (suprasternal Doppler) and continuous noninvasive arterial pressure waveform (volume‐clamp method). Fourteen subjects were available for the current analyses. This experimental study found that pre‐ejection period increased with hypovolemia and remained unaltered with pain. Pulse transit time was reduced by pain and increased with hypovolemia. Thus, the direction of change in pulse transit time has the potential to distinguish hypovolemia and pain.https://doi.org/10.14814/phy2.15355hypovolemianon‐invasivepre‐ejection periodpulse transit time |
| spellingShingle | Håvard Djupedal Torkjell Nøstdahl Jonny Hisdal Svein Aslak Landsverk Lars Øivind Høiseth Effects of experimental hypovolemia and pain on pre‐ejection period and pulse transit time in healthy volunteers Physiological Reports hypovolemia non‐invasive pre‐ejection period pulse transit time |
| title | Effects of experimental hypovolemia and pain on pre‐ejection period and pulse transit time in healthy volunteers |
| title_full | Effects of experimental hypovolemia and pain on pre‐ejection period and pulse transit time in healthy volunteers |
| title_fullStr | Effects of experimental hypovolemia and pain on pre‐ejection period and pulse transit time in healthy volunteers |
| title_full_unstemmed | Effects of experimental hypovolemia and pain on pre‐ejection period and pulse transit time in healthy volunteers |
| title_short | Effects of experimental hypovolemia and pain on pre‐ejection period and pulse transit time in healthy volunteers |
| title_sort | effects of experimental hypovolemia and pain on pre ejection period and pulse transit time in healthy volunteers |
| topic | hypovolemia non‐invasive pre‐ejection period pulse transit time |
| url | https://doi.org/10.14814/phy2.15355 |
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