Catecholamine responses to central hypovolemia induced by lower body negative pressure and blood loss in humans (707.2)

Abstract

We tested the hypothesis that the catecholamine response would be similar during lower body negative pressure (LBNP) vs. blood loss (BL). Twelve men underwent randomized LBNP and BL protocols on the same day. LBNP consisted of 5‐minute stages at 0, ‐15, ‐30, and ‐45 mmHg of pressure. The BL protocol included 5 minutes at baseline and then after three stages of 333 ml of whole blood draws (1000 ml total) which were stored for reinfusion. Central venous pressure (CVP) was recorded during each protocol. Blood samples were collected at baseline and at the end of the last stage of each protocol. CVP was greater in LBNP vs. BL at baseline (7.3 ± 0.6 vs. 6.1 ± 0.6 mmHg; P < 0.01) and was lower during LBNP vs. BL (‐0.2 ± 0.6 vs. 1.8 ± 0.8 mmHg; P < 0.01). The increase in epinephrine (EPI) during LBNP (53 ± 7 vs.144 ± 30 pg/ml) and BL (49 ± 7 vs. 103 ± 19 pg/ml; P < 0.01) was similar (P = 0.16). An increase in norepinephrine (NE) during LBNP (148 ± 20 vs. 354 ± 44 pg/ml; P < 0.01) was greater (P < 0.01) than the trend to increase during BL (155 ± 22 vs. 211 ± 29 pg/ml; P = 0.09). Individual slopes of catecholamines vs. CVP were calculated to determine if the responses had similar trajectories between the two protocols. The EPI vs. CVP slope was steeper in LBNP vs. BL (‐13.5 ± 4.6 vs. ‐0.6 ± 0.1 pg/ml/mmHg; P < 0.01). The NE vs. CVP slope was steeper in LBNP vs. BL (‐27.8 ± 5.6 vs. ‐8.7 ± 5.9 pg/ml/mmHg; P = 0.01). LBNP to ‐45 mmHg appears to be a greater sympathetic stressor than 1000 ml of BL.Grant Funding Source: Supported by US Army MRMC Combat Casualty Care Research Program Grant # W81XWH‐11‐1‐0823