Mechanism of headward fluid shift during exposure to microgravity

Abstract

A prominent feature of early cardiovascular adaptation to the microgravity of space flight is a shift of blood and tissue fluid from the lower body to the upper body. Symptoms of this fluid shift include facial edema, nasal congestion, and headache. Normally on Earth, the human body is exposed to hydrostatic (gravitational) blood pressure gradients during upright posture. In this posture, mean arterial pressures at head, heart, and foot levels are approximately 70, 100, and 200 mm Hg, respectively. Theoretically, all hydrostatic pressures within arteries and veins are lost during exposure to microgravity so that mean arterial pressure in all regions of the body is uniform and approximately equal to that at heart level (100 mm Hg). Acute studies of 60 head-down tilt (simulated microgravity on Earth) indicate that facial edema is caused by: 1) elevation of capillary blood pressure from 28 to 34 mm Hg, 2) reduction of blood colloid osmotic pressure 22 to 18 mm Hg, and 3) 50% increase of blood perfusion in tissues of the head. Furthermore, as compared to microvasculature in the feet, microvessels of the head have a low capacity to constrict and diminish local perfusion. Elevation of blood and tissue fluid pressures/flow in the head may also explain the higher headward bone density associated with long-term head-down tilt. These mechanistic studies of head-down tilt, along with a better understanding of the relative stresses involved with upright posture and lower body negative pressure, have facilitated development of physiologic countermeasures to maintain astronaut health during microgravity. Presently no exercise hardware is available to provide a blood pressure gradient from head to feet in space. However, recent studies in our laboratory suggest that treadmill exercise within lower body negative pressure provides equivalent or greater physiologic stress as compared to similar upright exercise on Earth.