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Lower capacitance response and capillary fluid absorption in women to defend central blood volume in response to acute hypovolemic circulatory stress
Linköping University, Department of Medicine and Health Sciences, Physiology . Linköping University, Faculty of Health Sciences.
Helsingborg Hospital.
Linköping University, Department of Medicine and Health Sciences, Physiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.ORCID iD: 0000-0002-9095-403X
2008 (English)In: American Journal of Physiology. Heart and Circulatory Physiology, ISSN 0363-6135, Vol. 295, H867-H873 p.Article in journal (Refereed) Published
Abstract [en]

Acute hemorrhage is a leading cause of death in trauma, and women are more susceptible to hypovolemic circulatory stress than men. The mechanisms underlying the susceptibility are not clear, however. The aim of the present study was to examine the compensatory mechanisms to defend central blood volume during experimental hypovolemia in women and men. Twenty-two women (23.1 ± 0.4 yr) and 16 men (23.2 ± 0.5 yr) were included. A lower body negative pressure (LBNP) of 11–44 mmHg induced experimental hypovolemic circulatory stress. The volumetric technique was used to assess the capacitance response (redistribution of peripheral venous blood to the central circulation) as well as to assess net capillary fluid transfer from tissue to blood in the arm. Plasma norepinephrine (NE) and forearm blood flow were measured before and during hypovolemia, and forearm vascular resistance (FVR) was calculated. LBNP created comparable hypovolemia in women and men. FVR increased less in women during hypovolemic stress, and no association between plasma NE and FVR was seen in women (R2 = 0.01, not significant), in contrast to men (R2 = 0.59, P < 0.05). Women demonstrated a good initial capacitance response, but this was not maintained with time, in contrast to men [e.g., decreased by 24 ± 4% (women) vs. 4 ± 5% (men), LBNP of 44 mmHg, P < 0.01], and net capillary fluid absorption from tissue to blood was lower in women (0.086 ± 0.007 vs. 0.115 ± 0.011 ml·100 ml–1·min–1, P < 0.05). In conclusion, women showed impaired vasoconstriction, reduced capacitance response with time, and reduced capillary fluid absorption during acute hypovolemic circulatory stress, indicating less efficiency to defend central blood volume than men.

Place, publisher, year, edition, pages
2008. Vol. 295, H867-H873 p.
Keyword [en]
Gender, orthostatic tolerance, baroreceptor sensitivity
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-15418DOI: 10.1152/ajpheart.00332.2008OAI: oai:DiVA.org:liu-15418DiVA: diva2:114145
Available from: 2008-11-06 Created: 2008-11-06 Last updated: 2017-03-27Bibliographically approved
In thesis
1. Cardiovascular responses to hypovolemic circulatory stress in women: With special reference to venous compliance and capacitance
Open this publication in new window or tab >>Cardiovascular responses to hypovolemic circulatory stress in women: With special reference to venous compliance and capacitance
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Acute haemorrhage is a leading cause of death in trauma. Young women (YW) seem more susceptible to hypovolemic circulatory stress than young men (YM), but the underlying mechanisms are not clear. Elderly subjects are more vulnerable to haemorrhage, with a decreased defence of central blood volume in elderly men, but the defence has not been evaluated in elderly women  (EW). The aims were to assess differences in cardiovascular responses to hypovolemic circulatory stress, emphasizing compensatory mechanisms to maintain central blood volume in YW, EW and in women prone to vaso‐vagal reaction (VW).

Lower body negative pressure (LBNP) was used as a model for haemorrhage and to create acute hypovolemic stress. Volumetric techniques were used to assess venous compliance, capacitance and capillary fluid exchange both caused by LBNP in the calf and the response to maintain central blood volume.

LBNP induced a comparable hypovolemic stimulus in YW and YM, with lower calf venous compliance and capacitance but higher net capillary fluid filtration in YW. YW responded with smaller vasoconstriction without association between P‐NE and peripheral vascular resistance in contrast to YM. Venous capacitance response was decreased with time in YW. Further, net capillary fluid absorption from peripheral tissues to central circulation was decreased in YW in response to hypovolemic stress. All in all, this indicates less efficiency to defend central blood volume in young women.

Calf venous compliance and capacitance was maintained in EW compared to YW but capillary filtration was decreased, implying reduced capillary function with age. With increasing transmural pressures however, filtration and capillary filtration coefficient (CFC) increased indicating increased capillary susceptibility to transmural pressure load in dependent regions with age. Heart rate increase was attenuated in EW while peripheral vascular conductance was maintained suggesting reduced cardiovagal baroreceptor function in response to hypovolemia with age. Venous capacitance response and fluid absorption from peripheral tissues to central circulation were decreased with age, indicating less efficiency to defend central blood volume.

LBNP induced a slower hypovolemic stimulus in VW compared with nonvagal women. Further, the cardiopulmonary baroreflex was less efficient, and the venous capacitance response from peripheral tissues to central circulation was decreased, which may explain their susceptibility to orthostatic challenge.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2008. 70 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1087
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-15420 (URN)978-91-7393-756-6 (ISBN)
Public defence
2008-11-21, Elsa Brändström salen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 09:15 (English)
Opponent
Supervisors
Available from: 2008-11-06 Created: 2008-11-06 Last updated: 2017-04-15Bibliographically approved

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Lindenberger, MarcusLänne, Toste

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