1
|
Katagiri A, Fujii N, Dobashi K, Lai YF, Tsuji B, Nishiyasu T. Effects of sodium bicarbonate ingestion on ventilatory and cerebrovascular responses in resting heated humans. Am J Physiol Regul Integr Comp Physiol 2024; 327:R400-R409. [PMID: 39102461 DOI: 10.1152/ajpregu.00161.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 08/07/2024]
Abstract
Hyperthermia stimulates ventilation in humans. This hyperthermia-induced hyperventilation may be mediated by the activation of peripheral chemoreceptors implicated in the regulation of respiration in reaction to various chemical stimuli, including reductions in arterial pH. Here, we investigated the hypothesis that during passive heating at rest, the increases in arterial pH achieved with sodium bicarbonate ingestion, which could attenuate peripheral chemoreceptor activity, mitigate hyperthermia-induced hyperventilation. We also assessed the effect of sodium bicarbonate ingestion on cerebral blood flow responses, which are associated with hyperthermia-induced hyperventilation. Twelve healthy men ingested sodium bicarbonate (0.3 g/kg body weight) or sodium chloride (0.208 g/kg). One hundred minutes after the ingestion, the participants were passively heated using hot-water immersion (42°C) combined with a water-perfused suit. Increases in esophageal temperature (an index of core temperature) and minute ventilation (V̇E) during the heating were similar in the two trials. Moreover, when V̇E is expressed as a function of esophageal temperature, there were no between-trial differences in the core temperature threshold for hyperventilation (38.0 ± 0.3 vs. 38.0 ± 0.4°C, P = 0.469) and sensitivity of hyperthermia-induced hyperventilation as assessed by the slope of the core temperature-V̇E relation (13.5 ± 14.2 vs. 15.8 ± 15.5 L/min/°C, P = 0.831). Furthermore, middle cerebral artery mean blood velocity (an index of cerebral blood flow) decreased similarly with heating duration in both trials. These results suggest that sodium bicarbonate ingestion does not mitigate hyperthermia-induced hyperventilation and the reductions in cerebral blood flow index in resting heated humans.NEW & NOTEWORTHY Hyperthermia leads to hyperventilation and associated cerebral hypoperfusion, both of which may impair heat tolerance. This hyperthermia-induced hyperventilation may be mediated by peripheral chemoreceptors, which can be activated by reductions in arterial pH. However, our results suggest that sodium bicarbonate ingestion, which can increase arterial pH, is not an effective intervention in alleviating hyperthermia-induced hyperventilation and cerebral hypoperfusion in resting heated humans.
Collapse
Affiliation(s)
- Akira Katagiri
- Institute of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Naoto Fujii
- Institute of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
- Advanced Research Initiative for Human High Performance, University of Tsukuba, Ibaraki, Japan
| | - Kohei Dobashi
- Faculty of Education, Hokkaido University of Education, Hokkaido, Japan
| | - Yin-Feng Lai
- Institute of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Bun Tsuji
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Takeshi Nishiyasu
- Institute of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
- Advanced Research Initiative for Human High Performance, University of Tsukuba, Ibaraki, Japan
| |
Collapse
|
2
|
Gibbons TD, Dempsey JA, Thomas KN, Ainslie PN, Wilson LC, Stothers TAM, Campbell HA, Cotter JD. Carotid body hyperexcitability underlies heat-induced hyperventilation in exercising humans. J Appl Physiol (1985) 2022; 133:1394-1406. [PMID: 36302157 DOI: 10.1152/japplphysiol.00435.2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Physical activity is the most common source of heat strain for humans. The thermal strain of physical activity causes overbreathing (hyperventilation) and this has adverse physiological repercussions. The mechanisms underlying heat-induced hyperventilation during exercise are unknown, but recent evidence supports a primary role of carotid body hyperexcitability (increased tonic activity and sensitivity) underpinning hyperventilation in passively heated humans. In a repeated-measures crossover design, 12 healthy participants (6 female) completed two low-intensity cycling exercise conditions (25% maximal aerobic power) in randomized order, one with core temperature (TC) kept relatively stable near thermoneutrality, and the other with progressive heat strain to +2°C TC. To provide a complete examination of carotid body function under graded heat strain, carotid body tonic activity was assessed indirectly by transient hyperoxia, and its sensitivity estimated by responses to both isocapnic and poikilocapnic hypoxia. Carotid body tonic activity was increased by 220 ± 110% during cycling alone, and by 400 ± 290% with supplemental thermal strain to +1°C TC, and 600 ± 290% at +2°C TC (interaction, P = 0.0031). During exercise with heat stress at both +1°C and +2°C TC, carotid body suppression by hyperoxia decreased ventilation below the rates observed during exercise without heat stress (P < 0.0147). Carotid body sensitivity was increased by up to 230 ± 190% with exercise alone, and by 290 ± 250% with supplemental heating to +1°C TC and 510 ± 470% at +2°C TC (interaction, P = 0.0012). These data indicate that the carotid body is further activated and sensitized by heat strain during exercise and this largely explains the added drive to breathe.NEW & NOTEWORTHY Physical activity is the most common way humans increase their core temperature, and excess breathing in the heat can limit heat tolerance and performance, and may increase the risk of heat-related injury. Dose-dependent increases in carotid body tonic activity and sensitivity with core heating provide compelling evidence that carotid body hyperexcitability is the primary cause of heat-induced hyperventilation during exercise.
Collapse
Affiliation(s)
- Travis D Gibbons
- Centre for Heart, Lung and Vascular Health, University of British Columbia-Okanagan, School of Health and Exercise Science, Kelowna, British Columbia, Canada
| | - Jerome A Dempsey
- John Rankin Laboratory for Pulmonary Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Kate N Thomas
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, University of British Columbia-Okanagan, School of Health and Exercise Science, Kelowna, British Columbia, Canada
| | - Luke C Wilson
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Tiarna A M Stothers
- School of Physical Education, Sport & Exercise Sciences, University of Otago, Dunedin, New Zealand
| | - Holly A Campbell
- Department of Surgical Sciences, University of Otago, Dunedin, New Zealand
| | - James D Cotter
- School of Physical Education, Sport & Exercise Sciences, University of Otago, Dunedin, New Zealand
| |
Collapse
|
3
|
Gibbons TD, Dempsey JA, Thomas KN, Campbell HA, Stothers TAM, Wilson LC, Ainslie PN, Cotter JD. Contribution of the carotid body to thermally mediated hyperventilation in humans. J Physiol 2022; 600:3603-3624. [PMID: 35731687 DOI: 10.1113/jp282918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 06/15/2022] [Indexed: 01/05/2023] Open
Abstract
Humans hyperventilate under heat and cold strain. This hyperventilatory response has detrimental consequences including acid-base dysregulation, dyspnoea, decreased cerebral blood flow and accelerated brain heating. The ventilatory response to hypoxia is exaggerated under whole-body heating and cooling, indicating that altered carotid body function might contribute to thermally mediated hyperventilation. To address whether the carotid body might contribute to heat- and cold-induced hyperventilation, we indirectly measured carotid body tonic activity via hyperoxia, and carotid body sensitivity via hypoxia, under graded heat and cold strain in 13 healthy participants in a repeated-measures design. We hypothesised that carotid body tonic activity and sensitivity would be elevated in a dose-dependent manner under graded heat and cold strain, thereby supporting its role in driving thermally mediated hyperventilation. Carotid body tonic activity was increased in a dose-dependent manner with heating, reaching 175% above baseline (P < 0.0005), and carotid body suppression with hyperoxia removed all of the heat-induced increase in ventilation (P = 0.9297). Core cooling increased carotid body activity by up to 250% (P < 0.0001), but maximal values were reached with mild cooling and thereafter plateaued. Carotid body sensitivity to hypoxia was profoundly increased by up to 180% with heat stress (P = 0.0097), whereas cooling had no detectable effect on hypoxic sensitivity. In summary, cold stress increased carotid body tonic activity and this effect was saturated with mild cooling, whereas heating had clear dose-dependent effects on carotid body tonic activity and sensitivity. These dose-dependent effects with heat strain indicate that the carotid body probably plays a primary role in driving heat-induced hyperventilation. KEY POINTS: Humans over-breathe (hyperventilate) when under heat and cold stress, and though this has detrimental physiological repercussions, the mechanisms underlying this response are unknown. The carotid body, a small organ that is responsible for driving hyperventilation in hypoxia, was assessed under incremental heat and cold strain. The carotid body drive to breathe, as indirectly assessed by transient hyperoxia, increased in a dose-dependent manner with heating, reaching 175% above baseline; cold stress similarly increased the carotid body drive to breathe, but did not show dose-dependency. Carotid body sensitivity, as indirectly assessed by hypoxic ventilatory responses, was profoundly increased by 70-180% with mild and severe heat strain, whereas cooling had no detectable effect. Carotid body hyperactivity and hypersensitivity are two interrelated mechanisms that probably underlie the increased drive to breathe with heat strain, whereas carotid body hyperactivity during mild cooling may play a subsidiary role in cold-induced hyperventilation.
Collapse
Affiliation(s)
- Travis D Gibbons
- School of Physical Education, Sport & Exercise Science, University of Otago, Dunedin, Otago, New Zealand.,Centre for Heart, Lung and Vascular Health, School of Health and Exercise Science, University of British Columbia-Okanagan, Kelowna, British Columbia, Canada
| | - Jerome A Dempsey
- John Rankin Laboratory for Pulmonary Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Kate N Thomas
- Department of Surgical Sciences, University of Otago, Dunedin, Otago, New Zealand
| | - Holly A Campbell
- Department of Surgical Sciences, University of Otago, Dunedin, Otago, New Zealand
| | - Tiarna A M Stothers
- School of Physical Education, Sport & Exercise Science, University of Otago, Dunedin, Otago, New Zealand
| | - Luke C Wilson
- Department of Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Science, University of British Columbia-Okanagan, Kelowna, British Columbia, Canada
| | - James D Cotter
- School of Physical Education, Sport & Exercise Science, University of Otago, Dunedin, Otago, New Zealand
| |
Collapse
|
4
|
Katagiri A, Kitadai Y, Miura A, Fukuba Y, Fujii N, Nishiyasu T, Tsuji B. Sodium bicarbonate ingestion mitigates the heat-induced hyperventilation and reduction in cerebral blood velocity during exercise in the heat. J Appl Physiol (1985) 2021; 131:1617-1628. [PMID: 34590911 DOI: 10.1152/japplphysiol.00261.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Hyperthermia during exercise in the heat causes minute ventilation ([Formula: see text]) to increase, which leads to reductions in arterial CO2 partial pressure ([Formula: see text]) and cerebral blood flow. On the other hand, sodium bicarbonate ingestion reportedly results in metabolic alkalosis, leading to decreased [Formula: see text] and increased [Formula: see text] during prolonged exercise in a thermoneutral environment. Here, we investigated whether sodium bicarbonate ingestion suppresses heat-induced hyperventilation and the resultant hypocapnia and cerebral hypoperfusion during prolonged exercise in the heat. Eleven healthy men ingested a solution of sodium bicarbonate (0.3 g/kg body wt) (NaHCO3 trial) or sodium chloride (0.208 g/kg) (NaCl trial). Ninety minutes after the ingestion, the subjects performed a cycle exercise for 60 min at 50% of peak oxygen uptake in the heat (35°C and 40% relative humidity). Esophageal temperature did not differ between the trials throughout (P = 0.56, main effect of trial). [Formula: see text] gradually increased with exercise duration in the NaCl trial, but the increases in [Formula: see text] were attenuated in the NaHCO3 trial (P = 0.01, main effect of trial). Correspondingly, estimated [Formula: see text] and middle cerebral artery blood velocity (an index of anterior cerebral blood flow) were higher in the NaHCO3 than the NaCl trial (P = 0.002 and 0.04, main effects of trial). Ratings of perceived exertion were lower in the NaHCO3 than the NaCl trial (P = 0.02, main effect of trial). These results indicate that sodium bicarbonate ingestion mitigates heat-induced hyperventilation and reductions in [Formula: see text] and cerebral blood velocity during prolonged exercise in the heat.NEW & NOTEWORTHY Hyperthermia causes hyperventilation and concomitant hypocapnia and cerebral hypoperfusion. The cerebral hypoperfusion may underlie central fatigue. We demonstrate that sodium bicarbonate ingestion reduces heat-induced hyperventilation and attenuates hypocapnia-related cerebral hypoperfusion during prolonged exercise in the heat. In addition, we show that sodium bicarbonate ingestion reduces ratings of perceived exertion during the exercise. This study provides new insight into the development of effective strategies for preventing central fatigue during exercise in the heat.
Collapse
Affiliation(s)
- Akira Katagiri
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan.,Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Japan
| | - Yasuhiko Kitadai
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Akira Miura
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Yoshiyuki Fukuba
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Naoto Fujii
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Japan
| | - Takeshi Nishiyasu
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba City, Japan
| | - Bun Tsuji
- Department of Health Sciences, Prefectural University of Hiroshima, Hiroshima, Japan
| |
Collapse
|
5
|
Miyazawa T, Mizutani M, Sheahan JP, Ichikawa D. Intermittent face cooling reduces perceived exertion during exercise in a hot environment. J Physiol Anthropol 2021; 40:12. [PMID: 34488878 PMCID: PMC8420073 DOI: 10.1186/s40101-021-00262-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Facial cooling (FC) is effective in improving endurance exercise performance in hot environments. In this study, we evaluated the impact of intermittent short-lasting FC on the ratings of perceived exertion (RPE) during exercise. METHODS Ten healthy men performed 40 continuous minutes of ergometric cycle exercise at 65% of the peak heart rate in a climatic chamber controlled at an ambient temperature of 35 °C and a relative humidity of 50%. In the control (CONT) trial, the participants performed the exercise without FC. In two cooling trials, each participant underwent 10 s of FC at 2- (FC2) and 4-min (FC4) intervals while continuing to exercise. FC was achieved by applying two soft-gel packs (cooled to 0 °C) directly and bilaterally on the forehead, eyes, and cheeks. In another cooling trial, 10 s of FC was performed at 2-min intervals using two soft-gel packs cooled to 20 °C (FC2-20). RESULTS The RPE values in the FC4 trial were significantly lower than those in the CONT trial at 20 min (FC4, 11.6 ± 2.2 points; CONT, 14.2 ± 1.3 points; P < 0.01). Further, significant differences in the RPE values were observed between the FC4 and CONT trials at 5-15 min and 25-40 min (P < 0.05). RPE values were also significantly lower in the FC2 trial than in the CONT trial (5-40 min). Although the RPE values in the FC2-20 trial were significantly lower (5-10 min; 15-20 min) than those in the CONT trial, there were no significant differences in the RPE between the FC2-20 and CONT trials at 25-40 min. At 35 min, the RPE values were significantly higher in the FC2-20 trial than in the FC2 trial (P < 0.05). CONCLUSION Intermittent short-lasting FC was associated with a decrease in RPE, with shorter intervals and lower temperatures eliciting greater attenuation of increase in the RPE.
Collapse
Affiliation(s)
- Taiki Miyazawa
- Department of Health and Sports Science, Faculty of Wellness, Shigakkan University, Obu, Japan.
| | - Mirai Mizutani
- Department of Physical Education, Shigakkan University Junior College, Obu, Japan
| | | | - Daisuke Ichikawa
- Department of Biomedical Engineering, Toyo University, Kawagoe, Japan
| |
Collapse
|
6
|
Gibbons TD, Ainslie PN, Thomas KN, Wilson LC, Akerman AP, Donnelly J, Campbell HA, Cotter JD. Influence of the mode of heating on cerebral blood flow, non-invasive intracranial pressure and thermal tolerance in humans. J Physiol 2021; 599:1977-1996. [PMID: 33586133 DOI: 10.1113/jp280970] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/01/2021] [Indexed: 12/22/2022] Open
Abstract
KEY POINTS The human brain is particularly vulnerable to heat stress; this manifests as impaired cognition, orthostatic tolerance, work capacity and eventually, brain death. The brain's limitation in the heat is often ascribed to inadequate cerebral blood flow (CBF), but elevated intracranial pressure is commonly observed in mammalian models of heat stroke and can on its own cause functional impairment. The CBF response to incremental heat strain was dependent on the mode of heating, decreasing by 30% when exposed passively to hot, humid air (sauna), while remaining unchanged or increasing with passive hot-water immersion (spa) and exercising in a hot environment. Non-invasive intracranial pressure estimates (nICP) were increased universally by 18% at volitional thermal tolerance across all modes of heat stress, and therefore may play a contributing role in eliciting thermal tolerance. The sauna, more so than the spa or exercise, poses a greater challenge to the brain under mild to severe heating due to lower blood flow but similarly increased nICP. ABSTRACT The human brain is particularly vulnerable to heat stress; this manifests as impaired cognitive function, orthostatic tolerance, work capacity, and eventually, brain death. This vulnerability is often ascribed to inadequate cerebral blood flow (CBF); however, elevated intracranial pressure (ICP) is also observed in mammalian models of heat stroke. We investigated the changes in CBF with incremental heat strain under three fundamentally different modes of heating, and assessed whether heating per se increased ICP. Fourteen fit participants (seven female) were heated to thermal tolerance or 40°C core temperature (Tc ; oesophageal) via passive hot-water immersion (spa), passive hot, humid air exposure (sauna), cycling exercise, and cycling exercise with CO2 inhalation to prevent heat-induced hypocapnia. CBF was measured with duplex ultrasound at each 0.5°C increment in Tc and ICP was estimated non-invasively (nICP) from optic nerve sheath diameter at thermal tolerance. At thermal tolerance, CBF was decreased by 30% in the sauna (P < 0.001), but was unchanged in the spa or with exercise (P ≥ 0.140). CBF increased by 17% when end-tidal P C O 2 was clamped at eupnoeic pressure (P < 0.001). On the contrary, nICP increased universally by 18% with all modes of heating (P < 0.001). The maximum Tc was achieved with passive heating, and preventing hypocapnia during exercise did not improve exercise or thermal tolerance (P ≥ 0.146). Therefore, the regulation of CBF is dramatically different depending on the mode and dose of heating, whereas nICP responses are not. The sauna, more so than the spa or exercise, poses a greater challenge to the brain under equivalent heat strain.
Collapse
Affiliation(s)
- Travis D Gibbons
- University of Otago, 55/47 Union St. W, Dunedin, Otago, 9016, New Zealand
| | - Philip N Ainslie
- University of British Columbia, Okangan Campus, Kelowna, BC, V1V 1V7, Canada
| | - Kate N Thomas
- University of Otago, 55/47 Union St. W, Dunedin, Otago, 9016, New Zealand
| | - Luke C Wilson
- University of Otago, 55/47 Union St. W, Dunedin, Otago, 9016, New Zealand
| | | | | | - Holly A Campbell
- University of Otago, 55/47 Union St. W, Dunedin, Otago, 9016, New Zealand
| | - Jim D Cotter
- University of Otago, 55/47 Union St. W, Dunedin, Otago, 9016, New Zealand
| |
Collapse
|
7
|
Piil JF, Christiansen L, Morris NB, Mikkelsen CJ, Ioannou LG, Flouris AD, Lundbye-Jensen J, Nybo L. Direct exposure of the head to solar heat radiation impairs motor-cognitive performance. Sci Rep 2020; 10:7812. [PMID: 32385322 PMCID: PMC7210303 DOI: 10.1038/s41598-020-64768-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/22/2020] [Indexed: 02/02/2023] Open
Abstract
Health and performance impairments provoked by thermal stress are societal challenges geographically spreading and intensifying with global warming. Yet, science may be underestimating the true impact, since no study has evaluated effects of sunlight exposure on human brain temperature and function. Accordingly, performance in cognitively dominated and combined motor-cognitive tasks and markers of rising brainstem temperature were evaluated during exposure to simulated sunlight (equal to ~1000 watt/m2). Acute exposure did not affect any performance measures, whereas prolonged exposure of the head and neck provoked an elevation of the core temperature by 1 °C and significant impairments of cognitively dominated and motor task performances. Importantly, impairments emerged at considerably lower hyperthermia levels compared to previous experiments and to the trials in the presents study without radiant heating of the head. These findings highlight the importance of including the effect of sunlight radiative heating of the head and neck in future scientific evaluations of environmental heat stress impacts and specific protection of the head to minimize detrimental effects.
Collapse
Affiliation(s)
- Jacob F Piil
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark.
| | - Lasse Christiansen
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark.,Danish Research Centre for Magnetic Resonance, Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650, Hvidovre, Denmark
| | - Nathan B Morris
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark
| | - C Jacob Mikkelsen
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark
| | - Leonidas G Ioannou
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark.,FAME Laboratory, School of Exercise Science, University of Thessaly, Thessaly, Greece
| | - Andreas D Flouris
- FAME Laboratory, School of Exercise Science, University of Thessaly, Thessaly, Greece
| | - Jesper Lundbye-Jensen
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark
| |
Collapse
|
8
|
Effect of selective brain cooling versus core cooling on achieving target temperature among patients with severe traumatic brain injury. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2020. [DOI: 10.1016/j.ijans.2020.100209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
9
|
Seyedsaadat SM, Marasco SF, Daly DJ, McEgan R, Anderson J, Rodgers S, Kreck T, Kadirvel R, Kallmes DF. Selective brain hypothermia: feasibility and safety study of a novel method in five patients. Perfusion 2019; 35:96-103. [PMID: 31238794 PMCID: PMC7016355 DOI: 10.1177/0267659119853950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND/OBJECTIVE Reduction of brain temperature remains the most common method of neuroprotection against ischemic injury employed during cardiac surgery. However, cooling delivered via the cardiopulmonary bypass circuit is brief and cooling the body core along with the brain has been associated with a variety of unwanted effects. This study investigated the feasibility and safety of a novel selective brain cooling approach to induce rapid, brain-targeted hypothermia independent of the cardiopulmonary bypass circuit. METHODS This first-in-human feasibility study enrolled five adults undergoing aortic valve replacement with cardiopulmonary bypass support. During surgery, the NeuroSave system circulated chilled saline within the pharynx and upper esophagus. Brain and body core temperature were continuously monitored. Adverse effects, cardiopulmonary function, and device function were noted. RESULTS Patient 1 received cooling fluid for an insignificant period, and Patients 2-5 successfully underwent the cooling procedure using the NeuroSave system for 56-89 minutes. Cooling fluid was 12°C for Patients 1-3, 6°C for Patient 4, and 2°C for Patient 5. There were no NeuroSave-related adverse events and no alterations in cardiopulmonary function during NeuroSave use. Brain temperature decreased by 3°C within 15 minutes and remained at least 3.5°C colder than the body core. During a brief episode of hypotension in one patient, the brain cooled an additional 4°C in 2 minutes, briefly reaching 27.4°C. CONCLUSION The NeuroSave system can induce rapid brain-targeted hypothermia and simultaneously maintain a favorable body-brain temperature gradient, even during hypotension. Further studies are required to evaluate the function of the system during longer periods of use.
Collapse
Affiliation(s)
| | - Silvana F Marasco
- Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, VIC, Australia
| | - David J Daly
- Department of Anaesthesiology & Perioperative Medicine, The Alfred Hospital, Melbourne, VIC, Australia
| | - Robin McEgan
- Department of Perfusion, The Alfred Hospital, Melbourne, VIC, Australia
| | - James Anderson
- Department of Perfusion, The Alfred Hospital, Melbourne, VIC, Australia
| | | | | | | | | |
Collapse
|
10
|
Bright FM, Chaseling GK, Jay O, Morris NB. Self-paced exercise performance in the heat with neck cooling, menthol application, and abdominal cooling. J Sci Med Sport 2018; 22:371-377. [PMID: 30270195 DOI: 10.1016/j.jsams.2018.09.225] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/19/2018] [Accepted: 09/06/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To investigate whether the exercise performance benefits with neck cooling in the heat are attributable to neck-specific cooling, general body cooling, a cooler site-specific thermal perception or a combination of the above. DESIGN Counter-balanced crossover design. METHODS Twelve healthy participants cycled in the heat (34°C, 30% relative humidity), at a power output (PO) self-selected to maintain a fixed rating of perceived exertion (RPE) of 16. Each participant underwent four experimental trials: no cooling (CON), neck cooling (NEC), abdominal cooling (ABD), or neck cooling with menthol (MEN). Participants cycled for 90min or until their workload reduced by <70% of their initial PO. Changes in PO, rectal temperature (Tre), mean skin temperature (Tsk), whole-body thermal sensation (TSwb) and thermal sensation of the neck (TSneck) were recorded throughout. RESULTS The mean reduction in PO throughout exercise was similar (p=0.431) for CON (175±10W), NEC (176 ±12W), ABD (172±13W) and MEN (174±12W). The ΔTre at the end of exercise was similar (p=0.874) for CON (0.83±0.5°C), NEC (0.85±0.5°C), ABD (0.82±0.5°C) and MEN (0.81±0.5°C). TSwb was cooler (p<0.013) in MEN (125±8mm) compared to CON (146±19mm), NEC (135±11mm) and ABD (141±16mm). CONCLUSIONS No differences in exercise performance or thermal strain were observed in any of the cooling trials compared to the CON trial, despite significantly cooler TSwb values in the MEN and NEC trials compared to the CON trial. These findings differ from previous observations and highlight that the benefit of neck cooling may be situation dependent.
Collapse
Affiliation(s)
- Felicity M Bright
- Thermal Ergonomics Laboratory, Faculty of Health Sciences, University of Sydney, Australia
| | - Georgia K Chaseling
- Thermal Ergonomics Laboratory, Faculty of Health Sciences, University of Sydney, Australia
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Faculty of Health Sciences, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia
| | - Nathan B Morris
- Thermal Ergonomics Laboratory, Faculty of Health Sciences, University of Sydney, Australia; Center for Technology Research and Innovation, Cyprus; Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark.
| |
Collapse
|
11
|
Bain AR, Nybo L, Ainslie PN. Cerebral Vascular Control and Metabolism in Heat Stress. Compr Physiol 2016; 5:1345-80. [PMID: 26140721 DOI: 10.1002/cphy.c140066] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This review provides an in-depth update on the impact of heat stress on cerebrovascular functioning. The regulation of cerebral temperature, blood flow, and metabolism are discussed. We further provide an overview of vascular permeability, the neurocognitive changes, and the key clinical implications and pathologies known to confound cerebral functioning during hyperthermia. A reduction in cerebral blood flow (CBF), derived primarily from a respiratory-induced alkalosis, underscores the cerebrovascular changes to hyperthermia. Arterial pressures may also become compromised because of reduced peripheral resistance secondary to skin vasodilatation. Therefore, when hyperthermia is combined with conditions that increase cardiovascular strain, for example, orthostasis or dehydration, the inability to preserve cerebral perfusion pressure further reduces CBF. A reduced cerebral perfusion pressure is in turn the primary mechanism for impaired tolerance to orthostatic challenges. Any reduction in CBF attenuates the brain's convective heat loss, while the hyperthermic-induced increase in metabolic rate increases the cerebral heat gain. This paradoxical uncoupling of CBF to metabolism increases brain temperature, and potentiates a condition whereby cerebral oxygenation may be compromised. With levels of experimentally viable passive hyperthermia (up to 39.5-40.0 °C core temperature), the associated reduction in CBF (∼ 30%) and increase in cerebral metabolic demand (∼ 10%) is likely compensated by increases in cerebral oxygen extraction. However, severe increases in whole-body and brain temperature may increase blood-brain barrier permeability, potentially leading to cerebral vasogenic edema. The cerebrovascular challenges associated with hyperthermia are of paramount importance for populations with compromised thermoregulatory control--for example, spinal cord injury, elderly, and those with preexisting cardiovascular diseases.
Collapse
Affiliation(s)
- Anthony R Bain
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, Kelowna, Canada
| | - Lars Nybo
- Department of Nutrition, Exercise and Sport Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Philip N Ainslie
- Centre for Heart Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Okanagan Campus, Kelowna, Canada
| |
Collapse
|
12
|
Hu Z, Xu L, Zhu Z, Seal R, McQuillan PM. Effects of Hypothermic Cardiopulmonary Bypass on Internal Jugular Bulb Venous Oxygen Saturation, Cerebral Oxygen Saturation, and Bispectral Index in Pediatric Patients Undergoing Cardiac Surgery: A Prospective Study. Medicine (Baltimore) 2016; 95:e2483. [PMID: 26765454 PMCID: PMC4718280 DOI: 10.1097/md.0000000000002483] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The objective of this study was to evaluate the effect of hypothermic cardiopulmonary bypass (CPB) on cerebral oxygen saturation (rSO2), internal jugular bulb venous oxygen saturation (SjvO2), mixed venous oxygen saturation (SvO2), and bispectral index (BIS) used to monitor cerebral oxygen balance in pediatric patients.Sixty American Society of Anesthesiologists Class II-III patients aged 1 to 4 years old with congenital heart disease scheduled for elective cardiac surgery were included in this study. Temperature, BIS, rSO2, mean arterial pressure, central venous pressure, cerebral perfusion pressure (CPP), and hematocrit were recorded. Internal jugular bulb venous oxygen saturation and SvO2 were obtained from blood gas analysis at the time points: after induction of anesthesia (T0), beginning of CPB (T1), ascending aortic occlusion (T2), 20 minutes after initiating CPB (T3), coronary reperfusion (T4), separation from CPB (T5), and at the end of operation (T6). The effect of hypothermia or changes in CPP on rSO2, SjvO2, SvO2, and BIS were analyzed.Compared with postinduction baseline values, rSO2 significantly decreased at all-time points: onset of extracorporeal circulation, ascending aortic occlusion, 20 minutes after CPB initiation, coronary reperfusion, and separation from CPB (P < 0.05). Compared with measurements made following induction of anesthesia, SjvO2 significantly increased with initiation of CPB, ascending aortic occlusion, 20 minutes after initiating CPB, coronary reperfusion, and separation from CPB (P < 0.05). Compared with induction of anesthesia, BIS significantly decreased with the onset of CPB, aortic cross clamping, 20 minutes after initiating CPB, and coronary reperfusion (P < 0.05). Bispectral index increased following separation from CPB. There was no significant change in SvO2 during cardiopulmonary bypass (P > 0.05). Correlation analysis demonstrated that rSO2 was positively related to CPP (r = 0.687, P = 0.000), with a low linear correlation to temperature (r = 0.453, P = 0.000). Internal jugular bulb venous oxygen saturation was negatively related to temperature (r = -0.689, P = 0.000). Bispectral index was positively related to both temperature (r = 0.824, P = 0.000) and CPP (r = 0.782, P = 0.000). Cerebral oxygen saturation had a positive linear correlation with CPP and a low linear correlation to temperature. Internal jugular bulb venous oxygen saturation had a negative linear correlation to temperature.Pre-and and early postbypass periods are vulnerable times for adequate cerebral oxygenation. Anesthetic management must aim to optimize the supply and demand relationship.
Collapse
Affiliation(s)
- Zhiyong Hu
- From the Department of Anesthesiology, School of Medicine, The Children's Hospital, Zhejiang University (ZH, ZZ); Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China (LX); Department of Anesthesia and Pain Medicine, Stollery Children's Hospital, University of Alberta, Edmonton, Canada (RS); and Department of Anesthesiology, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, PA (PMM)
| | | | | | | | | |
Collapse
|
13
|
Sunderland C, Stevens R, Everson B, Tyler CJ. Neck-cooling improves repeated sprint performance in the heat. Front Physiol 2015; 6:314. [PMID: 26594177 PMCID: PMC4633514 DOI: 10.3389/fphys.2015.00314] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 10/19/2015] [Indexed: 11/13/2022] Open
Abstract
The present study evaluated the effect of neck-cooling during exercise on repeated sprint ability in a hot environment. Seven team-sport playing males completed two experimental trials involving repeated sprint exercise (5 × 6 s) before and after two 45 min bouts of a football specific intermittent treadmill protocol in the heat (33.0 ± 0.2°C; 53 ± 2% relative humidity). Participants wore a neck-cooling collar in one of the trials (CC). Mean power output and peak power output declined over time in both trials but were higher in CC (540 ± 99 v 507 ± 122 W, d = 0.32; 719 ± 158 v 680 ± 182 W, d = 0.24 respectively). The improved power output was particularly pronounced (d = 0.51-0.88) after the 2nd 45 min bout but the CC had no effect on % fatigue. The collar lowered neck temperature and the thermal sensation of the neck (P < 0.001) but had no effect on heart rate, fluid loss, fluid consumption, lactate, glucose, plasma volume change, cortisol, or thermal sensation (P > 0.05). There were no trial differences but interaction effects were demonstrated for prolactin concentration and rating of perceived exertion (RPE). Prolactin concentration was initially higher in the collar cold trial and then was lower from 45 min onwards (interaction trial × time P = 0.04). RPE was lower during the football intermittent treadmill protocol in the collar cold trial (interaction trial × time P = 0.01). Neck-cooling during exercise improves repeated sprint performance in a hot environment without altering physiological or neuroendocrinological responses. RPE is reduced and may partially explain the performance improvement.
Collapse
Affiliation(s)
- Caroline Sunderland
- Department of Sports Science, School of Science and Technology, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University Nottingham, UK
| | - Ryan Stevens
- Department of Sports Science, School of Science and Technology, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University Nottingham, UK
| | - Bethan Everson
- Department of Sports Science, School of Science and Technology, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University Nottingham, UK
| | | |
Collapse
|
14
|
Rattray B, Argus C, Martin K, Northey J, Driller M. Is it time to turn our attention toward central mechanisms for post-exertional recovery strategies and performance? Front Physiol 2015; 6:79. [PMID: 25852568 PMCID: PMC4362407 DOI: 10.3389/fphys.2015.00079] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 02/27/2015] [Indexed: 11/23/2022] Open
Abstract
Key PointsCentral fatigue is accepted as a contributor to overall athletic performance, yet little research directly investigates post-exercise recovery strategies targeting the brain Current post-exercise recovery strategies likely impact on the brain through a range of mechanisms, but improvements to these strategies is needed Research is required to optimize post-exercise recovery with a focus on the brain
Post-exercise recovery has largely focused on peripheral mechanisms of fatigue, but there is growing acceptance that fatigue is also contributed to through central mechanisms which demands that attention should be paid to optimizing recovery of the brain. In this narrative review we assemble evidence for the role that many currently utilized recovery strategies may have on the brain, as well as potential mechanisms for their action. The review provides discussion of how common nutritional strategies as well as physical modalities and methods to reduce mental fatigue are likely to interact with the brain, and offer an opportunity for subsequent improved performance. We aim to highlight the fact that many recovery strategies have been designed with the periphery in mind, and that refinement of current methods are likely to provide improvements in minimizing brain fatigue. Whilst we offer a number of recommendations, it is evident that there are many opportunities for improving the research, and practical guidelines in this area.
Collapse
Affiliation(s)
- Ben Rattray
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra Canberra, ACT, Australia ; University of Canberra Research Institute for Sport and Exercise, University of Canberra Canberra, ACT, Australia
| | - Christos Argus
- University of Canberra Research Institute for Sport and Exercise, University of Canberra Canberra, ACT, Australia
| | - Kristy Martin
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra Canberra, ACT, Australia ; University of Canberra Research Institute for Sport and Exercise, University of Canberra Canberra, ACT, Australia
| | - Joseph Northey
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra Canberra, ACT, Australia ; University of Canberra Research Institute for Sport and Exercise, University of Canberra Canberra, ACT, Australia
| | - Matthew Driller
- Department of Sport and Leisure Studies, The University of Waikato Hamilton, New Zealand
| |
Collapse
|
15
|
Brassard P, Ainslie PN, Secher NH. Cerebral oxygenation in health and disease. Front Physiol 2014; 5:458. [PMID: 25505422 PMCID: PMC4241837 DOI: 10.3389/fphys.2014.00458] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 11/07/2014] [Indexed: 12/26/2022] Open
Affiliation(s)
- Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec QC, Canada
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia-Okanagan Kelowna, BC, Canada
| | - Niels H Secher
- The Copenhagen Muscle Research Center, Department of Anesthesia, University of Copenhagen Copenhagen, Denmark
| |
Collapse
|