Lower body negative pressure protects brain perfusion in aviation gravitational stress induced by push–pull manoeuvre
Key points Rapid alterations of gravitational stress during high‐performance aircraft push–pull manoeuvres induce dramatic shifts in volume and pressure within the circulation system, which may result in loss of consciousness due to the rapid and significant reduction in cerebral perfusion. There ar...
Gespeichert in:
| Veröffentlicht in: | The Journal of physiology 2020-08, Vol.598 (15), p.3173-3186 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 3186 |
|---|---|
| container_issue | 15 |
| container_start_page | 3173 |
| container_title | The Journal of physiology |
| container_volume | 598 |
| creator | Xing, Changyang Wang, Xinpei Gao, Yuan Zhang, Jiaxin Liu, Yunnan Guo, Yitong Wang, Chen Feng, Yang Lei, Yujia Zhang, Xing Li, Jia Hu, Wendong Zhang, Shu Yuan, Lijun Gao, Feng |
| description | Key points
Rapid alterations of gravitational stress during high‐performance aircraft push–pull manoeuvres induce dramatic shifts in volume and pressure within the circulation system, which may result in loss of consciousness due to the rapid and significant reduction in cerebral perfusion. There are still no specific and effective countermeasures so far.
We found that lower body negative pressure (LBNP), applied prior to and during −Gz and released at the subsequent transition to +Gz, could effectively counteract gravitational haemodynamic stress induced by a simulated push–pull manoeuvre and improve cerebral diastolic perfusion in human subjects.
We developed a LBNP strategy that effectively protects cerebral perfusion at rapid −Gz to +Gz transitions via improving cerebral blood flow and blood pressure during push–pull manoeuvres and highlight the importance of the timing of the intervention.
Our findings provide a systemic link of integrated responses between the peripheral and cerebral haemodynamic changes during push–pull manoeuvres.
The acute negative (−Gz) to positive (+Gz) gravity stress during high‐performance aircraft push–pull manoeuvres dramatically reduces transient cerebral perfusion, which may lead to loss of vision or even consciousness. The aim of this study was to explore a specific and effective counteractive strategy. Twenty‐three healthy young male volunteers (age 21 ± 1 year) were subjected to tilting‐simulated push–pull manoeuvres. Lower body negative pressure (LBNP) of −40 mmHg was applied prior to and during −Gz stress (−0.50 or −0.87 Gz) and released at the subsequent transition to +1.00 Gz stress. Beat‐to‐beat cerebral and systemic haemodynamics were continuously recorded during the simulated push–pull manoeuvre in LBNP bouts and corresponding control bouts. During the rapid gravitational transition from −Gz to +Gz, the mean cerebral blood flow velocity decreased significantly in control bouts, while it increased in LBNP bouts (control vs. LBNP bouts, −6.6 ± 4.6 vs. 5.1 ± 6.8 cm s−1 for −0.50 Gz, and −7.4 ± 4.8 vs. 3.4 ± 4.6 cm s−1 for −0.87 Gz, P |
| doi_str_mv | 10.1113/JP279876 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2404048799</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2404048799</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3842-85091272f7cad01185a09b7ca56196213247906d4f8f7a24c5fef9db57cd8a433</originalsourceid><addsrcrecordid>eNp1kc9Kw0AQxhdRbK2CTyALXryk7p8ku3sU8V8p2EM9h00yqSlpEnezLb35Dr6hT-LWtiKCzGG-gd988M0gdE7JkFLKr0cTJpQU8QHq0zBWgRCKH6I-IYwFXES0h06snRNCOVHqGPU4C2kkZNRHq3GzAoPTJl_jGma6K5eAWwPWOrMRTQdZZ3FqdFnjFkzhbNnU2A96WXra65nxsvvWusK22yx7IHcZ5Dhd49bZ18_3j9ZVFV7ougG3NHCKjgpdWTjb9QF6ub-b3j4G4-eHp9ubcZBxGbJARkRRJlghMp0TSmWkiUr9EMVUxYz6IEKROA8LWQjNwiwqoFB5GokslzrkfICutr4-ypsD2yWL0mZQVbqGxtmEhcSXFEp59PIPOm-c8Zk2FJOcqfi3YWYaaw0USWvKhTbrhJJk84xk_wyPXuwMXbqA_AfcX98Dwy2wKitY_2uUTEcTGvqs_AtejpQk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2428329643</pqid></control><display><type>article</type><title>Lower body negative pressure protects brain perfusion in aviation gravitational stress induced by push–pull manoeuvre</title><source>Wiley Free Content</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Wiley Online Library All Journals</source><source>PubMed Central</source><creator>Xing, Changyang ; Wang, Xinpei ; Gao, Yuan ; Zhang, Jiaxin ; Liu, Yunnan ; Guo, Yitong ; Wang, Chen ; Feng, Yang ; Lei, Yujia ; Zhang, Xing ; Li, Jia ; Hu, Wendong ; Zhang, Shu ; Yuan, Lijun ; Gao, Feng</creator><creatorcontrib>Xing, Changyang ; Wang, Xinpei ; Gao, Yuan ; Zhang, Jiaxin ; Liu, Yunnan ; Guo, Yitong ; Wang, Chen ; Feng, Yang ; Lei, Yujia ; Zhang, Xing ; Li, Jia ; Hu, Wendong ; Zhang, Shu ; Yuan, Lijun ; Gao, Feng</creatorcontrib><description>Key points
Rapid alterations of gravitational stress during high‐performance aircraft push–pull manoeuvres induce dramatic shifts in volume and pressure within the circulation system, which may result in loss of consciousness due to the rapid and significant reduction in cerebral perfusion. There are still no specific and effective countermeasures so far.
We found that lower body negative pressure (LBNP), applied prior to and during −Gz and released at the subsequent transition to +Gz, could effectively counteract gravitational haemodynamic stress induced by a simulated push–pull manoeuvre and improve cerebral diastolic perfusion in human subjects.
We developed a LBNP strategy that effectively protects cerebral perfusion at rapid −Gz to +Gz transitions via improving cerebral blood flow and blood pressure during push–pull manoeuvres and highlight the importance of the timing of the intervention.
Our findings provide a systemic link of integrated responses between the peripheral and cerebral haemodynamic changes during push–pull manoeuvres.
The acute negative (−Gz) to positive (+Gz) gravity stress during high‐performance aircraft push–pull manoeuvres dramatically reduces transient cerebral perfusion, which may lead to loss of vision or even consciousness. The aim of this study was to explore a specific and effective counteractive strategy. Twenty‐three healthy young male volunteers (age 21 ± 1 year) were subjected to tilting‐simulated push–pull manoeuvres. Lower body negative pressure (LBNP) of −40 mmHg was applied prior to and during −Gz stress (−0.50 or −0.87 Gz) and released at the subsequent transition to +1.00 Gz stress. Beat‐to‐beat cerebral and systemic haemodynamics were continuously recorded during the simulated push–pull manoeuvre in LBNP bouts and corresponding control bouts. During the rapid gravitational transition from −Gz to +Gz, the mean cerebral blood flow velocity decreased significantly in control bouts, while it increased in LBNP bouts (control vs. LBNP bouts, −6.6 ± 4.6 vs. 5.1 ± 6.8 cm s−1 for −0.50 Gz, and −7.4 ± 4.8 vs. 3.4 ± 4.6 cm s−1 for −0.87 Gz, P < 0.01), which was attributed mainly to the elevation of diastolic flow. The LBNP bouts showed much smaller reduction of mean arterial blood pressure at the brain level than control bouts (control bouts vs. LBNP bouts, −38 ± 12 vs. −23 ± 10 mmHg for −0.50 to +1.00 Gz, and −62 ± 16 vs. −43 ± 11 mmHg for −0.87 to +1.00 Gz, P < 0.01). LBNP applied at −Gz and released at subsequent +Gz had biphasic counteractive effects against the gravitational responses to the push–pull manoeuvre. These data demonstrate that this LBNP strategy could effectively protect cerebral perfusion with dominant improvement of diastolic flow during push–pull manoeuvres.
Key points
Rapid alterations of gravitational stress during high‐performance aircraft push–pull manoeuvres induce dramatic shifts in volume and pressure within the circulation system, which may result in loss of consciousness due to the rapid and significant reduction in cerebral perfusion. There are still no specific and effective countermeasures so far.
We found that lower body negative pressure (LBNP), applied prior to and during −Gz and released at the subsequent transition to +Gz, could effectively counteract gravitational haemodynamic stress induced by a simulated push–pull manoeuvre and improve cerebral diastolic perfusion in human subjects.
We developed a LBNP strategy that effectively protects cerebral perfusion at rapid −Gz to +Gz transitions via improving cerebral blood flow and blood pressure during push–pull manoeuvres and highlight the importance of the timing of the intervention.
Our findings provide a systemic link of integrated responses between the peripheral and cerebral haemodynamic changes during push–pull manoeuvres.</description><identifier>ISSN: 0022-3751</identifier><identifier>EISSN: 1469-7793</identifier><identifier>DOI: 10.1113/JP279876</identifier><identifier>PMID: 32415785</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aviation ; Blood flow ; Blood Pressure ; Brain ; Cerebral blood flow ; Cerebrovascular Circulation ; Flow velocity ; Gravitation ; Gravity ; Hemodynamics ; Humans ; Lower Body Negative Pressure ; Male ; Perfusion ; push‐pull maneuver ; tilt ; Young Adult</subject><ispartof>The Journal of physiology, 2020-08, Vol.598 (15), p.3173-3186</ispartof><rights>2020 The Authors. The Journal of Physiology © 2020 The Physiological Society</rights><rights>2020 The Authors. The Journal of Physiology © 2020 The Physiological Society.</rights><rights>Journal compilation © 2020 The Physiological Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3842-85091272f7cad01185a09b7ca56196213247906d4f8f7a24c5fef9db57cd8a433</citedby><cites>FETCH-LOGICAL-c3842-85091272f7cad01185a09b7ca56196213247906d4f8f7a24c5fef9db57cd8a433</cites><orcidid>0000-0001-6555-1717 ; 0000-0003-1605-8285</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1113%2FJP279876$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1113%2FJP279876$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32415785$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xing, Changyang</creatorcontrib><creatorcontrib>Wang, Xinpei</creatorcontrib><creatorcontrib>Gao, Yuan</creatorcontrib><creatorcontrib>Zhang, Jiaxin</creatorcontrib><creatorcontrib>Liu, Yunnan</creatorcontrib><creatorcontrib>Guo, Yitong</creatorcontrib><creatorcontrib>Wang, Chen</creatorcontrib><creatorcontrib>Feng, Yang</creatorcontrib><creatorcontrib>Lei, Yujia</creatorcontrib><creatorcontrib>Zhang, Xing</creatorcontrib><creatorcontrib>Li, Jia</creatorcontrib><creatorcontrib>Hu, Wendong</creatorcontrib><creatorcontrib>Zhang, Shu</creatorcontrib><creatorcontrib>Yuan, Lijun</creatorcontrib><creatorcontrib>Gao, Feng</creatorcontrib><title>Lower body negative pressure protects brain perfusion in aviation gravitational stress induced by push–pull manoeuvre</title><title>The Journal of physiology</title><addtitle>J Physiol</addtitle><description>Key points
Rapid alterations of gravitational stress during high‐performance aircraft push–pull manoeuvres induce dramatic shifts in volume and pressure within the circulation system, which may result in loss of consciousness due to the rapid and significant reduction in cerebral perfusion. There are still no specific and effective countermeasures so far.
We found that lower body negative pressure (LBNP), applied prior to and during −Gz and released at the subsequent transition to +Gz, could effectively counteract gravitational haemodynamic stress induced by a simulated push–pull manoeuvre and improve cerebral diastolic perfusion in human subjects.
We developed a LBNP strategy that effectively protects cerebral perfusion at rapid −Gz to +Gz transitions via improving cerebral blood flow and blood pressure during push–pull manoeuvres and highlight the importance of the timing of the intervention.
Our findings provide a systemic link of integrated responses between the peripheral and cerebral haemodynamic changes during push–pull manoeuvres.
The acute negative (−Gz) to positive (+Gz) gravity stress during high‐performance aircraft push–pull manoeuvres dramatically reduces transient cerebral perfusion, which may lead to loss of vision or even consciousness. The aim of this study was to explore a specific and effective counteractive strategy. Twenty‐three healthy young male volunteers (age 21 ± 1 year) were subjected to tilting‐simulated push–pull manoeuvres. Lower body negative pressure (LBNP) of −40 mmHg was applied prior to and during −Gz stress (−0.50 or −0.87 Gz) and released at the subsequent transition to +1.00 Gz stress. Beat‐to‐beat cerebral and systemic haemodynamics were continuously recorded during the simulated push–pull manoeuvre in LBNP bouts and corresponding control bouts. During the rapid gravitational transition from −Gz to +Gz, the mean cerebral blood flow velocity decreased significantly in control bouts, while it increased in LBNP bouts (control vs. LBNP bouts, −6.6 ± 4.6 vs. 5.1 ± 6.8 cm s−1 for −0.50 Gz, and −7.4 ± 4.8 vs. 3.4 ± 4.6 cm s−1 for −0.87 Gz, P < 0.01), which was attributed mainly to the elevation of diastolic flow. The LBNP bouts showed much smaller reduction of mean arterial blood pressure at the brain level than control bouts (control bouts vs. LBNP bouts, −38 ± 12 vs. −23 ± 10 mmHg for −0.50 to +1.00 Gz, and −62 ± 16 vs. −43 ± 11 mmHg for −0.87 to +1.00 Gz, P < 0.01). LBNP applied at −Gz and released at subsequent +Gz had biphasic counteractive effects against the gravitational responses to the push–pull manoeuvre. These data demonstrate that this LBNP strategy could effectively protect cerebral perfusion with dominant improvement of diastolic flow during push–pull manoeuvres.
Key points
Rapid alterations of gravitational stress during high‐performance aircraft push–pull manoeuvres induce dramatic shifts in volume and pressure within the circulation system, which may result in loss of consciousness due to the rapid and significant reduction in cerebral perfusion. There are still no specific and effective countermeasures so far.
We found that lower body negative pressure (LBNP), applied prior to and during −Gz and released at the subsequent transition to +Gz, could effectively counteract gravitational haemodynamic stress induced by a simulated push–pull manoeuvre and improve cerebral diastolic perfusion in human subjects.
We developed a LBNP strategy that effectively protects cerebral perfusion at rapid −Gz to +Gz transitions via improving cerebral blood flow and blood pressure during push–pull manoeuvres and highlight the importance of the timing of the intervention.
Our findings provide a systemic link of integrated responses between the peripheral and cerebral haemodynamic changes during push–pull manoeuvres.</description><subject>Adult</subject><subject>Aviation</subject><subject>Blood flow</subject><subject>Blood Pressure</subject><subject>Brain</subject><subject>Cerebral blood flow</subject><subject>Cerebrovascular Circulation</subject><subject>Flow velocity</subject><subject>Gravitation</subject><subject>Gravity</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Lower Body Negative Pressure</subject><subject>Male</subject><subject>Perfusion</subject><subject>push‐pull maneuver</subject><subject>tilt</subject><subject>Young Adult</subject><issn>0022-3751</issn><issn>1469-7793</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9Kw0AQxhdRbK2CTyALXryk7p8ku3sU8V8p2EM9h00yqSlpEnezLb35Dr6hT-LWtiKCzGG-gd988M0gdE7JkFLKr0cTJpQU8QHq0zBWgRCKH6I-IYwFXES0h06snRNCOVHqGPU4C2kkZNRHq3GzAoPTJl_jGma6K5eAWwPWOrMRTQdZZ3FqdFnjFkzhbNnU2A96WXra65nxsvvWusK22yx7IHcZ5Dhd49bZ18_3j9ZVFV7ougG3NHCKjgpdWTjb9QF6ub-b3j4G4-eHp9ubcZBxGbJARkRRJlghMp0TSmWkiUr9EMVUxYz6IEKROA8LWQjNwiwqoFB5GokslzrkfICutr4-ypsD2yWL0mZQVbqGxtmEhcSXFEp59PIPOm-c8Zk2FJOcqfi3YWYaaw0USWvKhTbrhJJk84xk_wyPXuwMXbqA_AfcX98Dwy2wKitY_2uUTEcTGvqs_AtejpQk</recordid><startdate>20200801</startdate><enddate>20200801</enddate><creator>Xing, Changyang</creator><creator>Wang, Xinpei</creator><creator>Gao, Yuan</creator><creator>Zhang, Jiaxin</creator><creator>Liu, Yunnan</creator><creator>Guo, Yitong</creator><creator>Wang, Chen</creator><creator>Feng, Yang</creator><creator>Lei, Yujia</creator><creator>Zhang, Xing</creator><creator>Li, Jia</creator><creator>Hu, Wendong</creator><creator>Zhang, Shu</creator><creator>Yuan, Lijun</creator><creator>Gao, Feng</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7TK</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6555-1717</orcidid><orcidid>https://orcid.org/0000-0003-1605-8285</orcidid></search><sort><creationdate>20200801</creationdate><title>Lower body negative pressure protects brain perfusion in aviation gravitational stress induced by push–pull manoeuvre</title><author>Xing, Changyang ; Wang, Xinpei ; Gao, Yuan ; Zhang, Jiaxin ; Liu, Yunnan ; Guo, Yitong ; Wang, Chen ; Feng, Yang ; Lei, Yujia ; Zhang, Xing ; Li, Jia ; Hu, Wendong ; Zhang, Shu ; Yuan, Lijun ; Gao, Feng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3842-85091272f7cad01185a09b7ca56196213247906d4f8f7a24c5fef9db57cd8a433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aviation</topic><topic>Blood flow</topic><topic>Blood Pressure</topic><topic>Brain</topic><topic>Cerebral blood flow</topic><topic>Cerebrovascular Circulation</topic><topic>Flow velocity</topic><topic>Gravitation</topic><topic>Gravity</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Lower Body Negative Pressure</topic><topic>Male</topic><topic>Perfusion</topic><topic>push‐pull maneuver</topic><topic>tilt</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xing, Changyang</creatorcontrib><creatorcontrib>Wang, Xinpei</creatorcontrib><creatorcontrib>Gao, Yuan</creatorcontrib><creatorcontrib>Zhang, Jiaxin</creatorcontrib><creatorcontrib>Liu, Yunnan</creatorcontrib><creatorcontrib>Guo, Yitong</creatorcontrib><creatorcontrib>Wang, Chen</creatorcontrib><creatorcontrib>Feng, Yang</creatorcontrib><creatorcontrib>Lei, Yujia</creatorcontrib><creatorcontrib>Zhang, Xing</creatorcontrib><creatorcontrib>Li, Jia</creatorcontrib><creatorcontrib>Hu, Wendong</creatorcontrib><creatorcontrib>Zhang, Shu</creatorcontrib><creatorcontrib>Yuan, Lijun</creatorcontrib><creatorcontrib>Gao, Feng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of physiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xing, Changyang</au><au>Wang, Xinpei</au><au>Gao, Yuan</au><au>Zhang, Jiaxin</au><au>Liu, Yunnan</au><au>Guo, Yitong</au><au>Wang, Chen</au><au>Feng, Yang</au><au>Lei, Yujia</au><au>Zhang, Xing</au><au>Li, Jia</au><au>Hu, Wendong</au><au>Zhang, Shu</au><au>Yuan, Lijun</au><au>Gao, Feng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lower body negative pressure protects brain perfusion in aviation gravitational stress induced by push–pull manoeuvre</atitle><jtitle>The Journal of physiology</jtitle><addtitle>J Physiol</addtitle><date>2020-08-01</date><risdate>2020</risdate><volume>598</volume><issue>15</issue><spage>3173</spage><epage>3186</epage><pages>3173-3186</pages><issn>0022-3751</issn><eissn>1469-7793</eissn><abstract>Key points
Rapid alterations of gravitational stress during high‐performance aircraft push–pull manoeuvres induce dramatic shifts in volume and pressure within the circulation system, which may result in loss of consciousness due to the rapid and significant reduction in cerebral perfusion. There are still no specific and effective countermeasures so far.
We found that lower body negative pressure (LBNP), applied prior to and during −Gz and released at the subsequent transition to +Gz, could effectively counteract gravitational haemodynamic stress induced by a simulated push–pull manoeuvre and improve cerebral diastolic perfusion in human subjects.
We developed a LBNP strategy that effectively protects cerebral perfusion at rapid −Gz to +Gz transitions via improving cerebral blood flow and blood pressure during push–pull manoeuvres and highlight the importance of the timing of the intervention.
Our findings provide a systemic link of integrated responses between the peripheral and cerebral haemodynamic changes during push–pull manoeuvres.
The acute negative (−Gz) to positive (+Gz) gravity stress during high‐performance aircraft push–pull manoeuvres dramatically reduces transient cerebral perfusion, which may lead to loss of vision or even consciousness. The aim of this study was to explore a specific and effective counteractive strategy. Twenty‐three healthy young male volunteers (age 21 ± 1 year) were subjected to tilting‐simulated push–pull manoeuvres. Lower body negative pressure (LBNP) of −40 mmHg was applied prior to and during −Gz stress (−0.50 or −0.87 Gz) and released at the subsequent transition to +1.00 Gz stress. Beat‐to‐beat cerebral and systemic haemodynamics were continuously recorded during the simulated push–pull manoeuvre in LBNP bouts and corresponding control bouts. During the rapid gravitational transition from −Gz to +Gz, the mean cerebral blood flow velocity decreased significantly in control bouts, while it increased in LBNP bouts (control vs. LBNP bouts, −6.6 ± 4.6 vs. 5.1 ± 6.8 cm s−1 for −0.50 Gz, and −7.4 ± 4.8 vs. 3.4 ± 4.6 cm s−1 for −0.87 Gz, P < 0.01), which was attributed mainly to the elevation of diastolic flow. The LBNP bouts showed much smaller reduction of mean arterial blood pressure at the brain level than control bouts (control bouts vs. LBNP bouts, −38 ± 12 vs. −23 ± 10 mmHg for −0.50 to +1.00 Gz, and −62 ± 16 vs. −43 ± 11 mmHg for −0.87 to +1.00 Gz, P < 0.01). LBNP applied at −Gz and released at subsequent +Gz had biphasic counteractive effects against the gravitational responses to the push–pull manoeuvre. These data demonstrate that this LBNP strategy could effectively protect cerebral perfusion with dominant improvement of diastolic flow during push–pull manoeuvres.
Key points
Rapid alterations of gravitational stress during high‐performance aircraft push–pull manoeuvres induce dramatic shifts in volume and pressure within the circulation system, which may result in loss of consciousness due to the rapid and significant reduction in cerebral perfusion. There are still no specific and effective countermeasures so far.
We found that lower body negative pressure (LBNP), applied prior to and during −Gz and released at the subsequent transition to +Gz, could effectively counteract gravitational haemodynamic stress induced by a simulated push–pull manoeuvre and improve cerebral diastolic perfusion in human subjects.
We developed a LBNP strategy that effectively protects cerebral perfusion at rapid −Gz to +Gz transitions via improving cerebral blood flow and blood pressure during push–pull manoeuvres and highlight the importance of the timing of the intervention.
Our findings provide a systemic link of integrated responses between the peripheral and cerebral haemodynamic changes during push–pull manoeuvres.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32415785</pmid><doi>10.1113/JP279876</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0001-6555-1717</orcidid><orcidid>https://orcid.org/0000-0003-1605-8285</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0022-3751 |
| ispartof | The Journal of physiology, 2020-08, Vol.598 (15), p.3173-3186 |
| issn | 0022-3751 1469-7793 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2404048799 |
| source | Wiley Free Content; MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Wiley Online Library All Journals; PubMed Central |
| subjects | Adult Aviation Blood flow Blood Pressure Brain Cerebral blood flow Cerebrovascular Circulation Flow velocity Gravitation Gravity Hemodynamics Humans Lower Body Negative Pressure Male Perfusion push‐pull maneuver tilt Young Adult |
| title | Lower body negative pressure protects brain perfusion in aviation gravitational stress induced by push–pull manoeuvre |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-30T17%3A54%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Lower%20body%20negative%20pressure%20protects%20brain%20perfusion%20in%20aviation%20gravitational%20stress%20induced%20by%20push%E2%80%93pull%20manoeuvre&rft.jtitle=The%20Journal%20of%20physiology&rft.au=Xing,%20Changyang&rft.date=2020-08-01&rft.volume=598&rft.issue=15&rft.spage=3173&rft.epage=3186&rft.pages=3173-3186&rft.issn=0022-3751&rft.eissn=1469-7793&rft_id=info:doi/10.1113/JP279876&rft_dat=%3Cproquest_cross%3E2404048799%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2428329643&rft_id=info:pmid/32415785&rfr_iscdi=true |