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Tissue gas stores of the body and head-out immersion in humans.

Breath-by-breath gas exchange was studied in 10 subjects during and after transitions between dry conditions and head-out immersion in thermoneutral conditions. Cardiac index (CI) was estimated by means of impedance cardiography. Previous largely qualitative models of changes in tissue gas stores after blood volume shifts could be confirmed and extended to include a quantitative analysis of O2 and CO2 tissue stores. An increase in CI by 47.0% during immersion was associated with an increase in the tissue O2 stores by 122 ml/m2 and a decrease in the tissue CO2 stores by 148 ml/m2. The time constants for the recovery of O2 uptake (tau O2) and CO2 elimination after initial increases after the dry-to-immersion transition were 32.4 and 79.3 s, respectively. The decrease in CI on return to the dry conditions was associated with a drop in tissue O2 stores and a tau O2 of 144 s. The increase in tissue O2 stores during immersion as well as the difference in tau O2 between the two transitions were larger than could be explained by the change in CI only. This was attributed to changes in the distributions of peripheral blood flow and venous blood volume. Compared with the O2 stores, the decrease in CO2 stores was better predicted by the change in CI. The present results emphasize that the changes in pulmonary and tissue gas exchange imposed by head-out immersion transients mainly reflect movement of gas in and out of body stores.

Adolescent↗

Does gender influence human cardiovascular and renal responses to water immersion?

We hypothesized that women and men exhibit similar cardiovascular and renal responses to thermoneutral water immersion (WI) to the neck. Ten women and nine men underwent two sessions in random order: 1) seated nonimmersed for 5.5 h (control) and 2) WI for 3 h, with subjects seated nonimmersed for 1.5 h pre- and 1 h postimmersion. We measured left atrial diameter, heart rate, arterial pressure, urine volume and osmolality, and urinary endothelin, urodilatin, sodium, and potassium excretion. No significant difference existed between groups in cardiovascular responses. The groups also exhibited mostly similar renal responses to immersion after adjustment for body mass. However, female urodilatin excretion per kilogram during immersion was over twofold that of men, and the female kaliuretic response to immersion was delayed and less pronounced relative to that in men. Men may excrete more potassium than women during immersion because men possess greater lean body mass (potassium per kilogram). Results obtained in men during WI may be cautiously extrapolated to women, yet urodilatin and potassium responses exhibit gender differences.

Adult↗

Comparison of thermoregulatory responses between men and women immersed in cold water.

Eleven women (age = 24.4 +/- 6.3 yr, mass = 65.0 +/- 7.8 kg, height = 167 +/- 8 cm, body fatness = 22.4 +/- 5.9%, mean +/- SD) were immersed to neck level in 18 degrees C water for up to 90 min for comparison of their thermal responses with those of men (n = 14) in a previous similarly conducted protocol. Metabolic rate increased about three times resting levels in men and women, whereas the rate of rectal temperature cooling (DeltaT(re)/Deltat) in women (0.47 degrees C/h) was about one-half that in men. With use of all data, DeltaT(re)/Deltat correlates with the ratio of body surface area to size and the metabolic rate of shivering correlates inversely to the square root of body fatness. No significant gender differences in total metabolic heat production normalized for body mass or surface area were found among subjects who completed 90 min of immersion (9 women and 7 men). Nor was there a gender difference in the overall percent contribution ( approximately 60%) of fat oxidation to total heat production. Blood concentrations of free fatty acids, glycerol, beta-hydroxybutyrate, and lactate increased significantly during the 90-min immersion, whereas muscle glycogen sampled from the right quadriceps femoris vastus lateralis decreased (free fatty acids, glycerol, and beta-hydroxybutyrate were higher in women). When the subjects were subgrouped according to similar body fatness and 60 min of immersion (6 women and 5 men), no significant gender differences emerged in DeltaT(re)/Deltat, energy metabolism, and percent fat oxidation. These findings suggest that no gender adjustments are necessary for prediction models of cold response if body fatness and the ratio of body surface area to size are taken into account and that a potential gender advantage with regard to carbohydrate sparing during cold water immersion is not supported.

Adipose Tissue↗

Cardiovascular and respiratory responses to apneas with and without face immersion in exercising humans.

The effect of the diving response on alveolar gas exchange was investigated in 15 subjects. During steady-state exercise (80 W) on a cycle ergometer, the subjects performed 40-s apneas in air and 40-s apneas with face immersion in cold (10 degrees C) water. Heart rate decreased and blood pressure increased during apneas, and the responses were augmented by face immersion. Oxygen uptake from the lungs decreased during apnea in air (-22% compared with eupneic control) and was further reduced during apnea with face immersion (-25% compared with eupneic control). The plasma lactate concentration increased from control (11%) after apnea in air and even more after apnea with face immersion (20%), suggesting an increased anaerobic metabolism during apneas. The lung oxygen store was depleted more slowly during apnea with face immersion because of the augmented diving response, probably including a decrease in cardiac output. Venous oxygen stores were probably reduced by the cardiovascular responses. The turnover times of these gas stores would have been prolonged, reducing their effect on the oxygen uptake in the lungs. Thus the human diving response has an oxygen-conserving effect.

Adult↗

Increased release of the N-terminal and C-terminal portions of the atrial natriuretic factor prohormone during immersion-induced central hypervolemia in cirrhotic humans.

The role of peptides from the N-terminus and C-terminus of the 126 amino acid (a.a.) atrial natriuretic factors (ANF) prohormone in modulating renal sodium and water handling in cirrhotic patients has not been defined. Eight cirrhotic individuals were evaluated; their mean basal circulating concentration of the C-terminus (a.a. 99-126; i.e., ANF) was 25 +/- 2 fmol/ml, not different from the 22 +/- 1 fmol/ml value found in 54 normal volunteers. On the other hand, the basal circulating concentrations of the whole N-terminus (a.a. 1-98) and the midportion of the N-terminus (namely a.a. 31-67; pro ANF 31-67) of the ANF prohormone in these cirrhotic subjects of 704 +/- 52 and 654 +/- 83 fmol/ml were significantly elevated (p less than 0.05; ANOVA) in comparison to control values (531 +/- 25, 317 +/- 22 fmol/ml, respectively). Following equilibration on a 10 mmol/day sodium diet, the responsiveness of the N-terminus and C-terminus of ANF prohormone to 3 h of water immersion, which induces marked acute central volume expansion, was evaluated in these 8 seated cirrhotic patients. There was a prompt increase in the circulating concentrations of immunoreactive (ir) pro ANF 1-98 (whole N-terminus), ir pro ANF 31-67, and ir ANF (C-terminus) within 15 min of immersion (p less than 0.05; ANOVA) compared to their preimmersion values. The response of circulating ir pro ANF 1-98, pro ANF 31-67, and ANF concentrations in these 8 cirrhotic subjects to immersion was significantly greater (p less than 0.05; ANOVA) than that of 7 healthy volunteers undergoing an identical 3-hour immersion study. With cessation of immersion, the C-terminus decreased within 30 min to a concentration not significantly different from preimmersion values, whereas the N-terminus and pro ANF 31-67 remained significantly elevated after 1 h.

Adult↗

Improvement of renal failure with repeated head-out water immersions in patients with hepatorenal syndrome associated with alcoholic hepatitis.

Two patients with severe hepatorenal syndrome associated with alcoholic hepatitis are reported, in whom repeated daily courses of head-out water immersion were dramatically effective in producing an improvement of the renal function. Using repeated 2-hour courses of head-out water immersion for 7 days in the 1st patient, an immediate increase in urine output was observed. A slight increase in renal sodium excretion was also noted. The patient lost 7 kg over 1 week. Serum creatinine decreased from 520 to 370 mumol/l, and the renal function continued to improve thereafter. In the 2nd patient, repeated head-out water immersion was associated with a progressive improvement of the renal function, an effect that was absent during an initial therapy of volume load. The acute effects of immersion in in this 2nd patient were characterized by a dramatic increase in urine output and renal sodium excretion as well as in p-aminohippurate and creatinine clearances. These effects were associated with a decrease in the activity of the renin-angiotensin system and a modest increase in plasma atrial natriuretic peptide levels. Thus, these 2 cases emphasize the potential benefits of repeated head-out water immersions in improving the renal function of patients with hepatorenal syndrome.

Adult↗

Changes in gastric mucosal content of adenosine, xanthine and hypoxanthine induced by restrained water immersion stress: antiulcer effects of tetraprenylacetone.

The purpose of this study was to clarify the involvement of adenine nucleotide metabolism and substrates of the xanthine-xanthine oxidase system as the source of oxygen free radicals in a rat model of restrained water immersion stress ulceration. The gastric mucosal concentrations of adenine-5'-triphosphate (ATP), adenine-5'-diphosphate (ADP), adenine-5'-monophosphate (AMP) and thiobarbituric-acid (TBA)-reactant substances were measured after 4, 8 and 12 h restrained water immersion stress. The gastric mucosal concentrations of the nucleoside adenosine, the purine bases xanthine and hypoxanthine, and the final metabolic product uric acid, were measured after 4 h of restrained water immersion stress. The concentrations of ATP diminished significantly after 4, 8 and 12 h of restrained water immersion stress. However, the observed stress-induced changes in ADP were not significant. AMP concentrations increased significantly after 4, 8 and 12 h of stress. The adenylate pool (ATP + ADP + AMP) dropped significantly from the prestress value after 4, 8 and 12 h of stress, and the concomitant energy charge (EC = ATP + 0.5 ADP/ATP + ADP + AMP) decreased significantly after 4 and 8 h of stress compared with the prestress value. Gastric mucosal concentrations of TBA-reactant substances displayed a significant increase after 4 h of stress, and remained unchanged after 8 and 12 h of stress from the level after 4 h. Four hours of restrained water immersion stress induced an increase in adenosine and uric acid concentrations and a decrease in the hypoxanthine concentration of the gastric mucosa.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenine Nucleotides↗

Effects of partial isothermic immersion on the spirometry parameters of tetraplegic patients.

STUDY OBJECTIVES: Our objective was to compare under controlled conditions the effect of immersion on spirometry parameters of patients with tetraplegia vs those of normal individuals. DESIGN AND PATIENTS: Twenty-three otherwise well tetraplegic subjects were compared to a control group of 11 similar healthy subjects before and during 5 to 15 min of isothermal immersion in water to shoulder level. RESULTS: Measured at baseline, tetraplegic subjects exhibited significant pulmonary restriction, characterized by a mean FVC of 54.9 +/- 14.6% of the predicted value (range, 23.2 to 80.4%), whereas all controls subjects had > 80% of predicted values. Immersion increased the FVC of tetraplegic patients an average of 18.4 +/- 18.7% above basal measurements, while that of the control group worsened (DeltaFVC, - 8.8 +/- 4.4%). Among the tetraplegic patients, the lower the preimmersion vital capacity, the greater the percentage of improvement following immersion (r = 0.79; 95% confidence interval, - 0.91 to - 0.56; p < 0.0001). No relationship was found between the time elapsed since cervical cord injury or its level and the degree of improvement. CONCLUSIONS: Water activities play an important role in the rehabilitation of patients with spinal cord injury. Immersion in isothermal water at shoulder level, under strictly controlled experimental conditions, reduces the vital capacity of normal individuals, while it improves in a group of patients with tetraplegia. The observed phenomenon seems to be mediated by an improvement in breathing mechanics, impaired by cervical cord injury.

Adult↗

[Changes in the forearm tcPO2 following the cold water immersion test].

The purpose of this study is to apply changes in forearm transcutaneous PO2 (tcPO2) during the cold water immersion test (5 degrees C, for 10 min) to the diagnosis of vibration syndrome. Forearm tcPO2 in healthy controls increased gradually up to 3 min after the start of the cold water immersion and decreased thereafter. It returned to almost the same level before immersion 5 min after the start. In the workers using vibrating tools manifesting Raynaud's phenomenon, forearm tcPO2 also increased up to 3 min after the start as in healthy controls, but no change was observed thereafter. The difference between the level of forearm tcPO2 at 3 min and that at 10 min after the start of the immersion (Forearm tcPO2 recovery index, newly devised by authors) in workers using vibrating tools was significantly lower than that in healthy controls. Therefore, investigation of changes in forearm tcPO2 following the cold water immersion test is considered to be a useful objective item which can contribute to the diagnosis of vibration syndrome.

Aged↗

Does shivering thermogenesis enhance the individual's ability to maintain rectal temperature during immersion in cold water?

Shivering thermogenesis may enable individuals to maintain rectal temperature during acute cold exposure. This data analysis revisited this hypothesis and compared previously published data with unpublished data from our laboratory on those subjects that were terminated from cold water immersion early because of a reduction in rectal temperature (T(re)) - 35 degrees C. T(re), mean skin temperature (T(sk)), and oxygen uptake (VO2) were recorded at 5, 30, 60, and 90 min of immersion and were used to calculate 3delta readings for each exposure, that is, deltaT(30) minus T5, T60 minus T(30), and T(90) minus T(60). Single group t-tests were used to examine differences in deltaT(re), deltaT(sk), and deltaVO2 between the published data (PD) group and the individual subjects who were terminated early (TE) at each of three water temperatures (18 degrees C, 22 degrees C, 26 degrees C). For deltaVO2 the TE subjects were dichotomized by fatness (low percent fat, 8%-12%; or high percent fat, 18%-22%) to account for the VO2 differences between these groups (i.e., fatness) during cold water immersion. deltaT(re) was significantly (p < 0.05) decreased in TE subjects compared with PD subjects at all timepoints for 18 degrees C and 26 degrees C. At 22 degrees C, the TE subject exhibited a significantly greater (p < 0.05) decrease in deltaT(re) than the PD group at 90 min of immersion only. No significant (p > 0.05) differences in deltaT(sk) between the PD and TE groups were detected for any of the exposure temperatures over all time points. No difference (p > 0.05) between PD subjects and TE subjects for deltaVO2 was exhibited at any time point at any temperature. It appears that with respect to the TE group, elevations in VO2 were comparable to the PD group, but the TE group was unable to maintain T(re) during cold water immersion. In conclusion, from these data it appears that shivering thermogenesis does in part enhance the individual's ability to maintain T(re); however, as evidenced in the TE group, it also appears that the alterations in shivering thermogenesis for certain individuals may not be great enough to offset heat loss.

Adult↗

The immersion foot syndrome. 1946.

1. Prolonged exposure of the extremities to cold insufficient to cause tissue freezing produces a well-defined syndrome. 'Immersion foot' is one of the descriptive but inaccurate terms applied to this syndrome. The clinical features, aetiology, pathology, prevention, and treatment of immersion foot are considered in detail. A discussion on pathogenesis is also included. 2. In the natural history of a typical case of immersion foot there are four stages: the period of exposure and the pre-hyperaemic, hyperaemic, and post-hyperaemic stages. 3. During exposure and immediately after rescue the feet are cold, numb, swollen, and pulseless. Intense vasoconstriction sufficient to arrest blood-flow is believed to be the predominant factor during this phase. 4. This is followed by a period of intense hyperaemia, increased swelling, and severe pain. Hyperaemia is due to the release in chilled and ischaemic tissues of relatively stable vasodilator metabolites; pain may be the result of relative anoxia of sensory nerve-endings. 5. Within 7-10 days of rescue the intense hyperaemia and swelling subside and pain diminishes in intensity. A lesser degree of hyperaemia may persist for several weeks. Objective disturbances of sensation and sweating and muscular atrophy and paralysis now become apparent. These findings are correlated with damage to the peripheral nerves. 6. After several weeks the feet become cold-sensitive; when exposed to low temperature they cool abnormally and may remain cold for several hours. Hyperhidrosis frequently accompanies this cold-sensitivity. The factors responsible for these phenomena are incompletely understood; several possible explanations are considered. 7. Severe cases may develop blisters and gangrene. The latter is usually superficial and massive loss of tissue is rare. 8. The hands may be affected but seldom as severely as the feet. The essential features of immersion hand are the same as those of immersion foot. 9. Prognosis depends upon severity. The extent of anaesthesia at 7-10 days has been found a useful guide to the latter, and has formed a basis of a method of classification. 10. Rapid warming of chilled tissues is condemned. Cold therapy is of value for the relief of pain in the hyperaemic stage, but should not be used in the pre-hyperaemic stage. Sympathectomy and other measures designed to increase the peripheral circulation should not be employed immediately after rescue, but may have a place in the treatment of the later cold-sensitive state. This paper records the results of observations made during 1941 and 1942. Delay in publication has been necessary because of war-time difficulties of maintaining contact between authors. In this respect we have received much help from Surgeon Rear-Admiral J. W. McNee. We wish to thank Professors R. S. Aitken and J. R. Learmonth for much helpful advice during the preparation of the paper. The charts have been prepared by the technical staff of the Wilkie Surgical Research Laboratory, University of Edinburgh. During the period of the study, one of us (R. L. R.) was in receipt of a personal grant from the Medical Research Council.

Body Temperature Regulation↗

Acute renal impairment after immersion and near-drowning.

Acute renal impairment (ARI) secondary to immersion and near-drowning is rarely described and poorly understood. A retrospective case-control study was performed: (1) to determine the incidence of ARI associated with near-drowning or immersion and (2) to define the clinical syndrome and to assess clinical predictors of ARI. Of 30 patients presenting after immersion or near-drowning, 50% were identified with ARI, with a mean admission serum creatinine of 0.24 +/- 0.33 mmol/L (2.7 +/- 3.7 mg/dl). These patients were a heterogeneous group: Eight had mild reversible ARI, three had ARI related to shock and multisystem failure, two had rhabdomyolysis-related ARI, and two had severe isolated ARI. Two patients required supportive hemodialysis and two died. Patients with ARI experienced more marked acidosis than control patients, as measured by serum bicarbonate (P < 0.001), pH (P < 0.001), and base excess (P < 0.001). There was also a higher admission lymphocyte count in the ARI group (P = 0.056). Dipstick hematuria on admission was significantly more common in patients with ARI (P = 0.016), and patients with 2 to 3+ of admission dipstick proteinuria had a higher peak serum creatinine than patients with less proteinuria (P < 0.05). Admission predictors of ARI by univariate logistic regression analysis included reduced serum bicarbonate (P = 0.002), pH (P = 0.001), and base excess (P < 0.001). The best predictor of ARI on multivariate analysis was a negative base excess (P = 0.01). In summary, acute renal impairment commonly occurs after immersion and near-drowning and is a heterogeneous condition. Although mild reversible renal impairment (serum creatinine < 0.30 mmol/L) (3.4 mg/dl) is usual, severe acute renal failure requiring dialysis can occur. It is recommended that any patient who presents after near-drowning or immersion should be assessed for potential ARI by serial estimations of serum creatinine, particularly when there is an increase in the initial serum creatinine, marked metabolic acidosis, an abnormal urinalysis, or a significant lymphocytosis.

Acute Disease↗

Thermal insulation and body temperature wearing a thermal swimsuit during water immersion.

This study evaluated the effects of a thermal swimsuit on body temperatures, thermoregulatory responses and thermal insulation during 60 min water immersion at rest. Ten healthy male subjects wearing either thermal swimsuits or normal swimsuits were immersed in water (26 degrees C or 29 degrees C). Esophageal temperature, skin temperatures and oxygen consumption were measured during the experiments. Metabolic heat production was calculated from oxygen consumption. Heat loss from skin to the water was calculated from the metabolic heat production and the change in mean body temperature during water immersion. Total insulation and tissue insulation were estimated by dividing the temperature difference between the esophagus and the water or the esophagus and the skin with heat loss from the skin. Esophageal temperature with a thermal swimsuit was higher than that with a normal swimsuit at the end of immersion in both water temperature conditions (p<0.05). Oxygen consumption, metabolic heat production and heat loss from the skin were less with the thermal swimsuit than with a normal swimsuit in both water temperatures (p<0.05). Total insulation with the thermal swimsuit was higher than that with a normal swimsuit due to insulation of the suit at both water temperatures (p<0.05). Tissue insulation was similar in all four conditions, but significantly higher with the thermal swimsuit in both water temperature conditions (p<0.05), perhaps due to of the attenuation of shivering during immersion with a thermal swimsuit. A thermal swimsuit can increase total insulation and reduce heat loss from the skin. Therefore, subjects with thermal swimsuits can maintain higher body temperatures than with a normal swimsuit and reduce shivering thermo-genesis.

Adult↗

Atrial type B receptor activity during head-out water immersion (HOWI) in dogs.

Single-fiber atrial type B receptor activity was recorded from the cervical vagus nerves in 8 dogs during head-out water immersion (HOWI) to simulate weightlessness. The receptor activity was not affected by the water immersion, changing insignificantly from 4.4 +/- 0.9 (SEM) impulses per cardiac cycle (imp/cycle) before HOWI to 4.3 +/- 0.5 imp/cycle immediately on HOWI. At the end of 30 min of HOWI, the receptor activity was 3.9 +/- 1.2 imp/cycle (p > 0.05) while immediately after the immersion it was 4.1 +/- imp/cycle again statistically insignificant (p > 0.05). When expressed as imp/min, the activity before HOWI (803 +/- 142) rose marginally to 826 +/- 116 at the beginning of immersion (p > 0.05), but this trend was not maintained. The urine flow which was measured in 4 female dogs in a different set of experiments, did, however, increase significantly immediately on immersion from 0.89 +/- 0.21 (SEM) to 1.9 +/- 0.35 ml/min (p < 0.02). Therefore, in the dog model developed for single-fiber study during HOWI, atrial type B receptor activity is not affected, and the diuresis which was observed during HOWI could be attributed to other mechanisms.

Animals↗

Autonomic nervous activity during hand immersion in cold water in patients with vibration-induced white finger.

Autonomic nervous function in response to cold was investigated in 21 patients with vibration-induced white finger (VWF) and 17 healthy controls of similar age, using power spectral analysis of heart rate variability. In a supine position, electrocardiogram and skin temperature of both index fingers were measured during immersion of right hand in cold water at 10 degrees C for 10 minutes. Autonomic nervous activity was evaluated from the power of the low-frequency component (LF: 0.02-0.15 Hz), the high-frequency component (HF: 0.15-0.40 Hz) and the ratio of the LF to the HF power (LF/HF ratio). The LF/HF ratio, an index of sympathetic nervous activity, significantly increased during the immersion in the VWF patients, but did not significantly increase in the controls. The LF/HF ratio was then significantly greater in the patients than in the controls during the first 1-2 minutes of the immersion. The HF power related to parasympathetic nervous activity did not change significantly in either group. Finger skin temperature of the immersed right hand was significantly lower in the VWF patients than in the controls during the last five minutes of the immersion and in the recovery period. The present results indicate that sympathetic nervous response to cold is significantly enhanced in VWF patients. The exaggerated sympathetic response to cold in these patients is considered to contribute to the enhanced vasoconstriction of their extremities.

Aged↗

The effect of drysuit diving in warm water on body temperature and post immersion orthostatic hypotension.

INTRODUCTION: Warm-water diving can limit heat dissipation, particularly when performed in fully encapsulating protective gear, leading to substantial thermal and cardiovascular strain that may impair diver safety. Following immersion, removal of hydrostatic support combined with heat-induced vasodilation may reduce central blood volume and increase susceptibility to orthostatic intolerance during egress and recovery. The extent to which this thermal strain impairs post-immersion orthostatic tolerance remains unknown. METHODS: Four randomised, crossover immersion trials were conducted at 28&#xb0;C, 33&#xb0;C, 38&#xb0;C without precooling (38&#xb0;C), and 38&#xb0;C with precooling (38&#xb0;C + Cool), with subjects wearing fully encapsulating dive gear. Subjects walked for up to 60 minutes at approximately 50% of O2max heart rate (HR) or until core temperature (Tc) reached 38.5&#xb0;C, or they voluntarily stopped. Tc, HR, and perceptual measures were recorded every 10 minutes. Orthostatic tolerance was assessed after immersion via a 70&#xb0; head-up tilt test. RESULTS: Eight healthy adults completed all aspects of the study. Tc and HR were higher during both 38&#xb0;C conditions compared with 28&#xb0;C and 33&#xb0;C (all P < 0.01) with no differences between 38&#xb0;C and 38&#xb0;C + Cool. Sweat loss exceeded 1.2 (SD 0.67) L&#x22c5;h-1 in both 38&#xb0;C conditions compared with &#x2264; 0.3 (0.32) L&#x22c5;h-1 at 28&#xb0;C and 33&#xb0;C (P < 0.01). Survival analysis showed orthostatic tolerance decreased with increasing thermal stress (log-rank P = 0.027; trend P = 0.003). Precooling did not reduce peak Tc or HR, nor did it improve tolerance time in 38&#xb0;C water. CONCLUSIONS: Encapsulated warm-water diving causes heat stress and cardiovascular strain that persists after immersion, impairing orthostatic tolerance. Precooling does not significantly reduce these outcomes.

Humans↗

Effect of water immersion on post-rotatory and caloric nystagmus.

Caloric nystagmus and post-rotatory nystagmus were recorded with and without head-out water immersion. As water immersion reduces body weight by about 90% owing to buoyancy, it decreases somatosensory inputs. Thus water immersion can be used to simulate a weightless environment. Caloric nystagmus was enhanced significantly by water immersion; however, post-rotatory nystagmus was not. These findings demonstrate that caloric nystagmus is easily affected by water immersion which decreases somatosensory inputs, but that post-rotatory nystagmus is not.

Caloric Tests↗

Release of kaliuretic peptide during immersion-induced central hypervolemia in healthy humans.

Kaliuretic peptide, a new peptide hormone consisting of amino acids 79-98 of the 126 amino acid atrial natriuretic factor (ANF) prohormone, is synthesized in the heart and is a potent stimulator of potassium excretion. The mechanism(s) controlling the release of kaliuretic peptide heretofore has not been defined. Because water immersion to the neck provides an acute central volume expansion identical to that produced by 2 liters of saline but without the plasma compositional change, immersion to the neck (NI) was utilized to assess kaliuretic peptide responses to acute central blood volume expansion in seven seated sodium-replete normal subjects. Since atrial natriuretic factor (ANF; amino acids 99-126 of the prohormone) originates from the amino acids adjacent to kaliuretic peptide in the ANF prohormone but is proteolytically cleaved from the rest of the prohormone before release, measurement of ANF was incorporated into this study to determine if there are differences with respect to release of these two portions of the ANF prohormone. Both kaliuretic peptide and ANF increased promptly with NI, with ANF peaking at 1 hr of immersion, whereas kaliuretic peptide peaked at the 3rd hr of immersion. With cessation of immersion, ANF decreased to preimmersion levels within 0.5 hr while kaliuretic peptide was still significantly (P < 0.05) elevated at 1 hr postimmersion. These findings indicate that kaliuretic peptide and ANF are released simultaneously but that kaliuretic peptide peak circulating concentration and its return to preimmersion values are prolonged compared with ANF. These last findings suggest a slower clearance from the circulation for kaliuretic peptide. The diuretic peak response to NI corresponded in a temporal manner to the peak circulating concentration of kaliuretic peptide, suggesting a possible physiologic role for kaliuretic peptide in modulating volume homeostasis in humans.

Adult↗