Continuous forearm cooling attenuates gastrointestinal temperature increase during cycling.

Hot environmental conditions can challenge thermoregulation resulting in exacerbated heat strain. This study evaluated the influence of continuous inner forearm cooling on gastrointestinal temperature (TGI) and physiological responses to exercise in hot (30°C) and humid (relative humidity: 70%) conditions. Eleven trained cyclists (seven male age: 37±12 years; four female age: 41±15 years; mean±standard deviation) performed two experimental trials, cycling at 66% of their self-reported functional threshold power (average work rate over an hour of maximum effort cycling; 175±34W) for 45 minutes in an environmental chamber. One trial employed continuous inner forearm cooling (COOL) with 5°C water passing through aluminum heat exchangers, while the other had no cooling (CONTROL). Heat was removed from the body at an average rate of 30.3±6.6W during the COOL trial resulting in an attenuation of TGI rise (CONTROL: 2.46±0.70, COOL: 2.03±0.63°C·h-1; p=0.002). The change in heart rate from the 10th minute to the end of exercise, as an indicator of cardiovascular drift, was reduced (CONTROL: 20±7, COOL: 17±6beats·min-1; p=0.050) and end-exercise thermal comfort was improved in the COOL trial with a trend for reduced rating of perceived exertion (p=0.055). Findings suggest that continuous cooling of the inner forearms can attenuate the rise of TGI and help mitigate the risk of heat injury during exercise in hot and humid conditions.

Carotid sinus pressure changes during push-pull maneuvers.

INTRODUCTION: The push-pull maneuver (PPM) is defined as a reduction in G-tolerance when positive acceleration (+Gz) immediately follows negative acceleration (-Gz) exposure, with the carotid baroreceptors presumably playing a dominant role in the ensuing BP (SBP) responses. The objective of this study was to determine whether application of neck pressure (NP) during the preceding -Gz phase maintains +Gz tolerance during subsequent +Gz. METHODS: There were 10 experienced men who were exposed to 3 centrifuge run types using a multi-axis centrifuge: a relaxed control run from +1.4 baseline to visual tolerance; a relaxed control PPM run (PPM-C) consisting of 5 s of -1 Gz followed by 15 s of +Gz to visual tolerance; and an experimental PPM run performed with pressurized neck (PPM-NP) consisting of -1 Gz for 5 s followed by 15 s of +Gz at the previous PPM-C G-tolerance level. RESULTS: Relaxed control G tolerance (3.6 _ 0.26 Gz) was greater vs. the PPM-C (3.0 +/- 0.21 Gz) and PPM-NP (3.1 +/- 0.20 Gz) conditions, but the two PPM conditions did not differ significantly. During -Gz, mean R-R interval for PPM-NP was significantly shorter than in the PPM-C from second 1 to second 3. During the +Gz phase, however, R-R interval responses between PPM-C and PPM-NP differed only at seconds 8 and 9. There were no differences in carotid sinus SBP between PPM-C and PPM-NP during -Gr. During +Gz, carotid sinus SBP was significantly depressed in PPM-NP and PPM-C conditions vs. Control. DISCUSSION: Application of NP during the -Gz phase, despite altering R-R interval, did not ameliorate SBP responses or reductions in G tolerance during subsequent +Gz exposure. Despite neck compression counteracting increased carotid hydrostatic pressure during -Gz, the carotid baroreceptor response is likely opposed by the aortic or other baroreceptors.

Impairment of cardiovascular and vasomotor responses during tilt table simulation of "push-pull' maneuvers.

BACKGROUND: Numerous studies have shown that tolerance to positive acceleration (+Gz) is impaired subsequent to an exposure of less than +1 Gz. HYPOTHESIS: Vasodilation induced by antecedent negative Gz (-Gz) exposure delays sympathetic vasoconstriction during subsequent +Gz, further reducing G-tolerance. METHODS: There were 20 subjects tested on an electronic tilt table, and exposed to the following randomized head-up tilt (HUT) and head-down tilt (HDT) conditions: +75 degrees HUT for 60 s, followed by transition to either 0 degrees (supine) HDT, or -25 degrees HDT, or -45 degrees HDT for 7 or 15 s at tilt rate of 45 degrees x s(-1). This was followed by HUT, divided into three periods: HUT1 (approximately 3-10 s), HUT2 (approximately 15-22 s), and HUT3 (approximately 27-35 s). Systolic blood pressure (SBP) was normalized to heart and head-levels. Stroke volume (SV) was estimated using impedance cardiography; forearm blood flow (FBF) estimated by venous occlusion plethysmography and forearm vascular resistance (FVR) was calculated from FBF and SBP. Total peripheral resistance (TPR) was estimated by MAP/(SV*HR). RESULTS: Heart-level SBP decreased significantly during HDT for both HDT durations (p < 0.01). SBP increased significantly at head-level during HDT (p < 0.001). During HUT1 heart and head-level SBP decreased for all conditions (p < 0.001), recovering to baseline levels by HUT2. TPR decreased significantly for all HDT conditions (p < 0.001), with this decrease related to the degree of HDT angle (p < 0.05). During HUT1, TPR remained depressed below baseline. At HUT2, TPR remained decreased for the -45 degrees/7-s condition only (p < 0.01). FBF decreased significantly during HDT (p < 0.02), with the magnitude related to the HDT angle. FBF remained elevated during HUT1 (p < 0.01). FVR decreased as a function of HDT angle during HDT (p < 0.001), with the decrease persisting into the HUT1 phase (p < 0.01). By the HUT2 and HUT3 periods, FVR were above baseline levels for the -45 degrees HDT condition (p < 0.01). CONCLUSION: These results confirm in humans the delayed recovery of peripheral vascular resistance observed in animal studies when -Gz precedes +Gz. Since SV recovered to baseline levels during the "pull" phase (HUT1-3), with TPR and forearm vascular resistance remaining depressed, baroreflex-mediated peripheral vascular control is delayed. This delay at higher subsequent +Gz levels is dangerous for the military pilot, since symptoms of G-intolerance due to delay in head-level BP recovery will ensue at lower absolute +Gz levels during push-pull type maneuvers.

Cardiovascular consequences of high-performance aircraft maneuvers: implications for effective countermeasures and laboratory-based simulations.

The gravitational stress encountered by pilots of high-performance aircraft can cause dramatic shifts in blood volume and circulatory pressure, thus placing the cardiovascular system under significant stress, sometimes resulting in loss of consciousness due to cerebral under-perfusion. Since pilots experience both increased and decreased gravitational stress in high-risk environments, it is important not only to examine the cardiovascular effects of altered gravitational exposure, but also to create effective countermeasures that will increase pilot safety. In this review, we discuss the cardiovascular consequences of rapid changes in gravitational forces. We also examine the effectiveness of the countermeasures that have been developed to combat gravity-induced loss of consciousness. Finally, we examine those current laboratory-based techniques that simulate hyper-gravity and the "push-pull effect"; making it possible to investigate the cardiovascular mechanisms responsible for maintaining cerebral perfusion and consciousness.