Body fluid distribution in man in space and effect of lower body negative pressure treatment.

Abstract

The lack of hydrostatic forces in space eventually produces a fluid deficit within the circulatory system. This deficit may alter the circulatory regulation patterns. The aim of the present study was to determine how much of this fluid deficit is attributable to interstitial fluid losses and to determine the effects of lower body negative pressure (LBNP) treatment on fluid distribution. The body fluid distribution of one subject was assessed before, during, and after weightlessness using two electrical impedance methods: (a) standard quadripole impedance for the segments of upper torso, lower torso, thigh, and calf and (b) an electrical impedance tomography technique (applied potential tomography) for a thigh cross-section. To assess the content of interstitial free fluid a thigh cuff overlying the electrodes for applied potential tomography was inflated to suprasystolic values to ascertain how much fluid can be squeezed out of blood vessels and tissue of skin and muscle. After the first thigh cuff maneuver (CUFF I) the subject performed a cardiovascular stress test with LBNP to mimic the gravity-induced blood shift to the lower part of the body. Then the compression maneuver was repeated (CUFF II). (a) This experimental sequence demonstrated a reduction in interstitial fluid in weightlessness of roughly 40% at the thigh. (b) The CUFF I and LBNP experiment demonstrated a reduced ability to cope with blood pooling in microgravity. (c) The CUFF II experiment suggests that LBNP in microgravity can refill the interstitial spaces and counteract the associated cardiovascular deterioration. The impedance measurements provided estimates of the contribution of different body sections to the observed body weight loss of more than 6 kg. The chest contributed nothing of significance, the lower torso more than 0.5 l, and both calves roughly 1.5 l. The thigh segments of both legs contributed between 1.5 l and 2.0 l with an interstitial free fluid reduction in muscle and skin by 40%.