Plasma volume, fluid shifts, and renal responses in humans during 12 h of head-out water immersion

Johansen, Lykke; Foldager, N.; Stadeager, C.; Kristensen, Michael Seltz; Bie, Peter; Warberg, Jørgen; Kamegai, Manabu; Norsk, Peter

doi:10.1152/jappl.1992.73.2.539

Cited by 52 publications

(44 citation statements)

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“…PV, SV, and CO are elevated and sustained throughout 6 to 12 h immersions compared to erect in air (348). These data support the contention that the intracellular reservoir of fluid is not diminished significantly during HOWI (185). CO is increased in HOWI and its level is greater for the erect posture, increasing from leg only immersion to mid-cervical HOWI.…”

Section: Circulatory Responses and Fluid Shiftssupporting

confidence: 68%

Human Physiology in an Aquatic Environment

Pendergast

Moon

Krasney

et al. 2015

Comprehensive Physiology

135

137

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Water covers over 70% of the earth, has varying depths and temperatures and contains much of the earth's resources. Head-out water immersion (HOWI) or submersion at various depths (diving) in water of thermoneutral (TN) temperature elicits profound cardiorespiratory, endocrine, and renal responses. The translocation of blood into the thorax and elevation of plasma volume by autotransfusion of fluid from cells to the vascular compartment lead to increased cardiac stroke volume and output and there is a hyperperfusion of some tissues. Pulmonary artery and capillary hydrostatic pressures increase causing a decline in vital capacity with the potential for pulmonary edema. Atrial stretch and increased arterial pressure cause reflex autonomic responses which result in endocrine changes that return plasma volume and arterial pressure to preimmersion levels. Plasma volume is regulated via a reflex diuresis and natriuresis. Hydrostatic pressure also leads to elastic loading of the chest, increasing work of breathing, energy cost, and thus blood flow to respiratory muscles. Decreases in water temperature in HOWI do not affect the cardiac output compared to TN; however, they influence heart rate and the distribution of muscle and fat blood flow. The reduced muscle blood flow results in a reduced maximal oxygen consumption. The properties of water determine the mechanical load and the physiological responses during exercise in water (e.g. swimming and water based activities). Increased hydrostatic pressure caused by submersion does not affect stroke volume; however, progressive bradycardia decreases cardiac output. During submersion, compressed gas must be breathed which introduces the potential for oxygen toxicity, narcosis due to nitrogen, and tissue and vascular gas bubbles during decompression and after may cause pain in joints and the nervous system.

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Section: Circulatory Responses and Fluid Shiftssupporting

confidence: 68%

Human Physiology in an Aquatic Environment

Pendergast

Moon

Krasney

et al. 2015

Comprehensive Physiology

135

137

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“…Plasma volume, stroke volume, and cardiac output remain elevated throughout 6-to 12-h immersions. These observations suggest that the intracellular reservoir of fluid is not significantly depleted during short-term immersion (47).…”

mentioning

confidence: 68%

The underwater environment: cardiopulmonary, thermal, and energetic demands

Pendergast¹,

Lundgren²

2009

Journal of Applied Physiology

128

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Pendergast DR, Lundgren CE. The underwater environment: cardiopulmonary, thermal, and energetic demands. J Appl Physiol 106: 276 -283, 2009. First published November 26, 2008 doi:10.1152/japplphysiol.90984.2008.-Water covers over 75% of the earth, has a wide variety of depths and temperatures, and holds a great deal of the earth's resources. The challenges of the underwater environment are underappreciated and more short term compared with those of space travel. Immersion in water alters the cardio-endocrine-renal axis as there is an immediate translocation of blood to the heart and a slower autotransfusion of fluid from the cells to the vascular compartment. Both of these changes result in an increase in stroke volume and cardiac output. The stretch of the atrium and transient increase in blood pressure cause both endocrine and autonomic changes, which in the short term return plasma volume to control levels and decrease total peripheral resistance and thus regulate blood pressure. The reduced sympathetic nerve activity has effects on arteriolar resistance, resulting in hyperperfusion of some tissues, which for specific tissues is time dependent. The increased central blood volume results in increased pulmonary artery pressure and a decline in vital capacity. The effect of increased hydrostatic pressure due to the depth of submersion does not affect stroke volume; however, a bradycardia results in decreased cardiac output, which is further reduced during breath holding. Hydrostatic compression, however, leads to elastic loading of the chest wall and negative pressure breathing. The depthdependent increased work of breathing leads to augmented respiratory muscle blood flow. The blood flow is increased to all lung zones with some improvement in the ventilation-perfusion relationship. The cardiac-renal responses are time dependent; however, the increased stroke volume and cardiac output are, during head-out immersion, sustained for at least hours. Changes in water temperature do not affect resting cardiac output; however, maximal cardiac output is reduced, as is peripheral blood flow, which results in reduced maximal exercise performance. In the cold, maximal cardiac output is reduced and skin and muscle are vasoconstricted, resulting in a further reduction in exercise capacity. respiratory; renal; immersion; exercise; aging; sex differences; submersion; pressure; energy cost THE UNDERWATER ENVIRONMENT is unique, and while it is a magical place with great history and beauty and plant and animal life and holds a wealth of resources, it also imposes pronounced physiological stresses on humans and animals. This brief review offers an overview of how the major environmental challenges, i.e., the pressure, temperature extremes, and the unbreathable ambient medium, of the "Silent World" affect circulation, renal system and water balance, breathing, exercise, and thermal balance and how it imposes some threats due to pharmacological or toxic effects of respired gases at high pressure, i.e., great depths. Adaptations to ...

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“…However, it has to be recognized that over peri ods of several days the use o f changes in Hct and PProt as indicators for changes in plasma volume is probably limited [for discussion see Johansen et al,21] (table 2).…”

Section: Plasma Paines Pnamentioning

confidence: 99%

Influence of Captopril on 24-Hour Balances and the Diurnal Patterns of Urinary Output, Blood Pressure, Aldosterone and Atrial Natriuretic Peptide in Conscious Dogs

Boemke¹,

Palm²,

Mohnhaupt³

et al. 1995

Kidney Blood Press Res

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The diurnal time course of urinary flow rate (UV), urinary sodium (U_NaV), and potassium (U_KV) excretion, and of hormones such as atrial natriuretic peptide (ANP) and aldosterone, was investigated during 5 days of continuous captopril infusion (15 µg · kg body weigth^-1 · min^-1) in 4 conscious dogs on a high sodium diet (14.5 mmol Na·kg body weigth^-1 24 h^-1). All food and water was given once daily at 8.30 a.m. On the control day and on days 1, 3, and 5 of·captopril infusion, urine was collected by an automated system at 20-min intervals over 24 h, blood was taken every 4 h. Mean arterial blood pressure (MABP) and heart rate were evaluated as 5-min averages. Time courses of U_NaV, UV, and UKV were compared with the individual control day without captopril. With captopril, 24-hour balances for Na and H₂0 were slightly negative, while the K balance was slightly positive for 2-3 days. Thereafter, all 24-hour balances were restored. MABP continued to decrease even after Na and water intake and output had come into balance again. Captopril treatment changed the diurnal excretion pattern for U_NaV and UV characteristically. In the postprandial period until 5 p.m., less Na and urine were excreted than on the control day, whereas during the evening and night more Na and urine were excreted. The changes in the excretion pattern persisted for the entire observation period. The results indicate that disturbances in the regulating systems, induced by converting-enzyme blockade, bring about complex reactions of, e.g., MABP ANP and aldosterone that finally restore Na and water 24-hour input/output balances.

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Plasma volume, fluid shifts, and renal responses in humans during 12 h of head-out water immersion

Cited by 52 publications

References 0 publications

Human Physiology in an Aquatic Environment

Human Physiology in an Aquatic Environment

The underwater environment: cardiopulmonary, thermal, and energetic demands

Influence of Captopril on 24-Hour Balances and the Diurnal Patterns of Urinary Output, Blood Pressure, Aldosterone and Atrial Natriuretic Peptide in Conscious Dogs

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