Twenty-four hours of bed rest with head-down tilt: venous and arteriolar changes of limbs

B. M. Pannier, P. J. Lacolley, C. Gharib, G. M. London, J. L. Cuche, J. L. Duchier, B. I. Levy and M. E. Safar Department of Internal Medicine, Broussais Hospital, France. The hemodynamic changes after 24 h of bed rest with -5 degree head-down tilt were studied in six normal subjects as a condition causing an intrathoracic shift of blood volume with a resulting urinary sodium and water loss and a subsequent reduction in total intravascular volume. Vascular resistance and venous tone of the upper and the lower limbs were investigated as were systemic hemodynamics throughout the procedure. Whereas systemic hemodynamic parameters did not change significantly, vascular resistance and venous tone of the upper and lower limbs decreased significantly up to the sixth h and then returned toward baseline values at 24 h. Systemic and forearm vasoconstriction responses to lower body negative pressure (LBNP) were studied just before and at the end of the study period. With LBNP, -5, -10, and -15 mmHg pressure levels were used to investigate mechanoreceptors in the low-pressure system, whereas the -40 mmHg pressure level was used to explore baroreceptors both in low and high pressure systems. Changes in vascular resistance in response to LBNP did not differ at the beginning and at the end of the head-down tilt, whereas an exaggerated heart rate response was observed at -40 mmHg at the end of 24 h of bed rest. The study showed that after 24 h of bed rest with -5 degree head-down tilt, the adaptative changes in venous tone and vascular resistance to blood volume reduction were altered. A dissociation between cardiac and vascular baroreflex response was observed in situations simulating tilting.