Upright posture reduces thermogenesis and augments core hypothermia

被引:14
作者
Nakajima, Y
Takamata, A
Ito, T
Sessler, DI
Kitamura, Y
Shimosato, G
Taniguchi, S
Matsuyama, H
Tanaka, Y
Mizobe, T
机构
[1] Kyoto Prefectural Univ Med, Dept Anesthesiol, Kamigyo Ku, Kyoto 6028566, Japan
[2] Kyoto Prefectural Univ Med, Dept Physiol, Kyoto 6028566, Japan
[3] Univ Louisville, Louisville, KY 40292 USA
[4] Univ Vienna, Ludwig Boltzmann Inst, A-1010 Vienna, Austria
关键词
D O I
10.1097/00000539-200206000-00053
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
We recently reported that baroreceptor-mediated reflexes modulate thermoregulatory vasoconstriction during lower abdominal surgery. Accordingly, we examined the hypothesis that postural differences and the related alterations in baroreceptor loading similarly modulate the thermogenic (i.e., shivering) response to hypothermia in humans. In healthy humans (n = 7), cold saline was infused W (30 mL/kg at 4degreesC) for 30 min to decrease core temperature. Each participant was studied on 2 separate days, once lying supine and once sitting uptight. Tympanic membrane temperature and oxygen consumption were monitored for 40 min after each saline infusion. The decrease in core temperature upon completion of the infusion in the upright posture position was 1.24degreesC +/- 0.07degreesC, which was significantly greater than the 1.02degreesC +/- 0.06degreesC seen in the supine position. The core temperature was reduced by 0.59degreesC +/- 0.07degreesC in the upright position but only by 0.37degreesC +/- 0.05degreesC in the supine position when the increase in oxygen consumption signaling thermogenic shivering occurred. Thus, the threshold temperature for thermogenesis was significantly less in the upright than the supine position. The gain of the thermogenic response did not differ significantly between the positions (363 +/- 69 mL.min(-1).degreesC(-1) for upright and 480 +/- 80 mL . min(-1) . degreesC(-1) for supine). The skin temperature gradient was significantly larger in the upright than in the supine posture, suggesting that the peripheral vasoconstriction was augmented by upright posture. Plasma norepinephrine concentrations increased in response to cold saline infusion under both conditions, but the increase was significantly larger in the upright than in the supine posture. Baroreceptor unloading thus augments the peripheral vasoconstrictor and catecholamine response to core hypothermia but simultaneously reduces thermogenesis, which consequently aggravated the core temperature decrease in the upright posture.
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收藏
页码:1646 / 1651
页数:6
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