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PubMed1999

Description of pressure ulcer pain at rest and at dressing change.

PURPOSE: To describe and compare the pain experienced by patients with stage II, III, and IV pressure ulcers both at rest and during dressing change. PATIENTS AND SETTING: Thirty-two subjects were recruited from acute, extended, and home care settings in the Midwest. The sample population ranged in age from 47 to 95 years (mean age 74.7 years, SD = 12.8), were white, and evenly divided between male and female patients. METHODS: Patients used the McGill Pain Questionnaire to rate their pressure ulcer pain at rest and again at dressing change. RESULTS: Twenty-eight subjects (87.5%) reported pain at dressing change and 27 (84.4%) experienced pain at rest, compared with 4 (12.5%) subjects who reported no pressure ulcer-related pain. Of the 28 reporting pain, 21 (75%) rated their pain as mild, discomforting, or distressing, and 5 (18%) described their pain as horrible or excruciating. Twelve (42%) reported their pain as continuous, occurring both at rest and during dressing changes. Despite these reports, only 2 (6%) subjects had received medication for their pressure ulcer pain. Although none of the hypotheses were statistically significant, we observed that patients with stage II, III, and IV pressure ulcers experienced pain. CONCLUSIONS: Within this study sample, the majority of patients had pressure ulcer-related pain, which for some was severe and constant. Therefore we conclude that the potential for pressure ulcer-related pain should be anticipated and assessed on a regular basis. In addition, further research is needed to increase our understanding of pressure ulcer pain and to find effective interventions for its relief.

Aged↗
PubMed2003

Single-blind trial addressing the differential effects of two reflexology techniques versus rest, on ankle and foot oedema in late pregnancy.

This single-blind randomised controlled trial explored the differential effects of two different foot reflexology techniques with a period of rest on oedema-relieving effects and symptom relief in healthy pregnant women with foot oedema. Fifty-five women in the third trimester were randomly assigned to one of the three groups: a period of rest, 'relaxing' reflexology techniques or a specific 'lymphatic' reflexology technique for 15 min with pre- and post-therapy ankle and foot circumference measurements and participant questionnaire. There was no statistically significant difference in the circumference measurements between the three groups; however, the lymphatic technique reflexology group mean circumference measurements were all decreased. A significant reduction in the women's symptom mean measurements in all groups (p<0.0001) was apparent. A 'perceived wellbeing' score revealed the lymphatic technique group (p<0.0001) significantly increased their wellbeing the most, followed closely by relaxing techniques (p<0.001) and then the control rest group (p<0.03). Lymphatic reflexology techniques, relaxing reflexology techniques and a period of rest had a non-significant oedema-relieving effect. From the women's viewpoint, lymphatic reflexology was the preferred therapy with significant increase in symptom relief.

Adult↗
PubMed2004

[Exercise limitation in patients with chronic obstructive pulmonary disease at the altitude of Bogota (2640 m). Breathing pattern and arterial gases at rest and peak exercise].

OBJECTIVE: To describe the response to exercise of normal subjects and patients with chronic obstructive pulmonary disease (COPD) in Bogota, Colombia (altitude: 2640 m; atmospheric pressure: 560 mm Hg) and compare it with data published on COPD patients at sea level. Healthy people increase their minute ventilation to attenuate hypoxemia (PaCO2: 30 mm Hg; PaO2: 63 mm Hg). MATERIAL AND METHOD: A descriptive study was carried out on healthy subjects and COPD patients. Exercise limitation was determined by an incremental test on a cycle ergometer. RESULTS: The study enrolled 16 healthy subjects and 25 COPD patients (forced expiratory volume in 1 second: 43.3% [SD 13%]). Minute ventilation at rest was greater in COPD patients compared with healthy subjects, it was not adequately sustained during exercise, and there was a reduction in peak oxygen uptake (53.0% [15%]). At peak exercise, inspiratory capacity decreased (-0.62 [0.34] L), the ratio of minute ventilation to maximal voluntary ventilation increased, and severe hypoxemia occurred (PaO2: 49.9 [9.9] mm Hg). There was significant correlation between hypoxemia and the percentage of predicted peak oxygen uptake (r=0.60), leg fatigue (r=-0.62), percentage of predicted peak inspiratory capacity (r=0.61), and the percentage of predicted peak tidal volume (r=0.49). Minute ventilation at rest was shown to be higher, there was a greater reduction in the inspiratory capacity during exercise, and hypoxemia was more severe at rest and during exercise for patients with COPD in Bogota, compared with those at sea level. CONCLUSIONS: Patients with COPD living in Bogota were shown to have lower tolerance to exercise evidenced by ventilatory limitation and severe hypoxemia. Increased minute ventilation at rest, greater reduction in inspiratory capacity, and severity of hypoxemia during exercise were the main differences between COPD in Bogota and at sea level.

Altitude↗
PubMed1999

Worsening of left ventricular diastolic function during long-term correction of anemia with erythropoietin in chronic hemodialysis patients--an assessment by radionuclide ventriculography at rest and exercise.

We studied the effect of correction of anemia with erythropoietin on left ventricular systolic and diastolic function at rest and exercise in 17 chronic hemodialysis patients by means of maximum exercise testing and equilibrium gated radionuclide angiocardiography on three occasions: 1) initial--before erythropoietin administration, 2) intermediate--at the time when the target hemoglobin level reached 100 g/l, and 3) long-term--after 12 months of therapy. After correction of anemia, the patients showed a significant improvement in their response to exercise regarding maximal work load achieved, exercise duration and recovery time. Ejection fraction and peak ejection rate remained unchanged during therapy. At rest, peak filling rate was reduced from 2.62 +/- 1.0 (baseline) to 2.28 +/- 0.9 (intermediate) end-diastolic volume per second, p < 0.01, while no significant difference was observed during exercise. The time to peak filling rate was prolonged significantly during EPO therapy from 157 +/- 30 to 177 +/- 28 ms at rest, p < 0.05, and from 101 +/- 24 to 130 +/- 27 ms during exercise, p < 0.01. By the time of the late study, there were no significant differences between the late and intermediate study. In conclusion, amelioration of anemia with erythropoietin in hemodialysis patients produced improvement in exercise capacity, but diastolic function worsened with therapy and this effect was maintained during the long-term treatment, while systolic function at rest and exercise remained unchanged.

Adult↗
PubMed2001

Inhibition of nitric oxide synthase with L-NAME does not increase lactate production at rest or during short-term high-intensity exercise in Thoroughbred horses.

The present study was carried out to determine whether inhibition of nitric oxide (NO) synthase promotes anaerobic metabolism in exercising horses, resulting in a significantly increased blood lactate concentration. N(omega)-nitro-L-arginine methyl ester (L-NAME) is a potent inhibitor of NO synthase that has been tested in horses and other species. Two sets of experiments, namely placebo (saline control) and L-NAME (20 mg/kg, i.v.) studies, were carried out on seven healthy, sound, exercise-trained, Thoroughbred horses in random order, 6 to 7 days apart. In both experiments, an incremental exercise protocol was used and data were obtained at rest, during submaximal exercise performed at 8 m/s on a 4.5% uphill grade, and during galloping at 14 m/s on a 4.5% uphill grade--a workload that not only elicited maximal heart rate and induced exercise-induced pulmonary haemorrhage, but also could not be sustained for more than 90 s. Measurements were also made in the recovery period. Mixed-venous blood samples, obtained at matched intervals in the two sets of experiments, were analysed in triplicate for determining the lactate concentration. Following administration of L-NAME, significant bradycardia occurred at rest (27 +/- 1 vs 37 +/- 2 beats/min in the placebo trials; p<0.0001) as well as during submaximal exercise (183 +/- 4 vs 200 +/- 4 beats/min in the placebo trials; p<0.001), but the heart rate increased during galloping at 14 m/s on a 4.5% uphill grade to reach values observed in the placebo trials (215 +/- 2 beats/min) and significant differences were not found. At rest, the mixed-venous blood lactate concentration was similar in the two experiments. With exercise, the mixed-venous blood lactate concentration increased progressively as work intensity increased in both trials, but significant differences were not found between the placebo and the L-NAME experiments during submaximal exercise, near-maximal exercise or recovery. These experiments demonstrated that inhibition of NO synthase in Thoroughbred horses does not promote enhanced anaerobic metabolism at rest or during short-term incremental exercise leading to galloping at maximal heart rate.

Animals↗
PubMed2000

Ventilatory variables in normal children during rest and exercise.

The aim of this study was to provide a complete description of normal ventilation at rest and exercise in children and to determine how best to correct for body size. One-hundred and six children aged 8-17 years (55 male) underwent incremental bicycle exercise testing from rest to exhaustion in 3 min, 15 W.m(-2) steps and thence through 9 min recovery. All variables were calculated using helium dilution mixed expired gas analysis together with measures of alveolar gas concentrations from continuous measurement at the mouth, all via an AMIS 2000 quadrupole mass spectrometer. Surface area was the best single measure to correct for body size but always explained <37% of the variance. Thus for example, surface area corrected oxygen consumption at rest in males was greater than females. Data is presented at rest, each work load and at "maximum" exercise. When presented per watt of work at each work load, this permits comparison of adaptability to exercise between sexes and age groups. Exercise appears to terminate when respiration reaches 45 and 40 breaths-min(-1) in males and females respectively and when alveolar oxygen concentrations rise. This simple protocol and near complete data set ought to permit accurate comparison with disease groups.

Adolescent↗
PubMed1985

Perception of expiratory flow by asthmatics and non-asthmatics during rest and exercise.

Perception of respiratory function may be an important factor in self-management of asthma. Previous research has suggested that asthmatics may not accurately perceive pulmonary functioning. The perception of normal and asthmatic individuals was assessed using a magnitude production procedure in a series of three studies, proceeding from normal individuals during rest, then submaximal exercise, to a comparison of normal and asthmatic adolescents during rest and submaximal exercise. At rest there were no differences between males and females, adults and adolescents, or asthmatics and non-asthmatics. However, there were significant differences in perception between rest and exercise for all groups. These findings suggest that a breakdown in perception does not occur during submaximal exercise in patients with asthma.

Adolescent↗
PubMed1984

Guanfacine in essential hypertension: effects during rest and isometric exercise.

The antihypertensive effects of guanfacine (0.5 to 4 mg daily) were investigated for 1 yr in 13 patients with essential hypertension. Blood pressure (BP) and heart rate (HR) response was measured during isometric exercise (handgrip) before starting the therapy, after 1 yr of treatment, and 2 wk after withdrawal. Guanfacine in once-daily dosage reduced BP during rest (supine BP: control, 175 +/- 6/103 +/- 4 mm Hg; 1 yr guanfacine, 161 +/- 5/91 +/- 3 mm Hg). Steady-state plasma concentrations after 1 yr were 4.1 +/- 0.59 ng/ml. Resting plasma norepinephrine (NE) and epinephrine (E) levels were lower during active therapy than 2 wk after withdrawal (guanfacine and control: plasma NE, 0.27 +/- 0.03/0.64 +/- 0.13 ng/ml; plasma E, 0.09 +/- 0.02/0.17 +/- 0.05 ng/ml). The relative reduction of plasma catecholamines (guanfacine and withdrawal) was of the same order during handgrip exercise as during supine rest. During isometric handgrip exercise, BP was lower during guanfacine therapy than before treatment and 2 wk after withdrawal, but the increment in BP during handgrip exercise was not affected by the drug despite the lower BP values on therapy. Our data indicate that the central alpha 2-agonist action of guanfacine reduces sympathoadrenal function equally during rest and isometric exercise.

Blood Pressure↗
PubMed1997

Cardiovascular effects of the novel Ca2+-sensitiser EMD 57033 in pigs at rest and during treadmill exercise.

1. To date no study has described the cardiovascular effects of increased myofilament Ca2+ responsiveness in awake animals both under resting conditions and during treadmill exercise. In the present study we therefore investigated the systemic, pulmonary and coronary haemodynamic actions of the Ca2+ sensitizer EMD 57033 in 16 chronically instrumented awake pigs at rest and during treadmill exercise, and compared these to the haemodynamic actions of the Ca2+ sensitizer/phosphodiesterase inhibitor pimobendan. 2. Under resting conditions EMD 57033 (0.2, 0.4 and 0.8 mg kg(-1) min(-1), i.v.) produced dose-dependent increases in LVdP/dt(max) (up to 65+/-17% (mean+/-s.e.mean), P < or = 0.05) and stroke volume (up to 20+/-3%, P < or = 0.05), with an increase in heart rate only after the highest dose (22+/-5%, P < or = 0.05), while mean aortic blood pressure and LVdP/dt(min) were not altered. EMD 57033 had also no effect on pulmonary vascular resistance, but produced dose-dependent decreases in systemic vascular resistance (32+/-4%, P < or = 0.05), and coronary vascular resistance (44+/-2%, P < or = 0.05). These effects were essentially unchanged when animals were pretreated with non-selective beta-adrenoceptor blockade, indicating that phosphodiesterase inhibition did not contribute to the positive inotropic actions of EMD 57033. 3. During exercise at 2, 3, and 4 km h(-1), the positive inotropic actions of EMD 57033 gradually waned at higher levels of exercise. This may have been caused by the exercise-induced increase in beta-adrenergic activity, because after pretreatment with propranolol the positive inotropic actions of EMD 57033 were preserved at all levels of exercise. In contrast, the positive inotropic and chronotropic effects of pimobendan were amplified during exercise, but were abolished (at rest) or markedly attenuated (during exercise) after pretreatment with propranolol. 4. The responses to EMD 57033 during exercise after combined alpha- and beta-adrenergic receptor blockade were not different from those after beta-adrenergic receptor blockade alone, indicating that the positive inotropic actions of EMD 57033 were not mediated via or did not depend on intact alpha-adrenergic receptor activity. 5. In conclusion, EMD 57033 increases left ventricular myocardial contractility in awake pigs. During exercise this effect is partially offset by the increased beta-adrenergic activity, with no effect of alpha-adrenergic activity, suggesting that EMD 57033 may be most effective in patients with severe loss of beta-adrenergic responsiveness.

Adrenergic alpha-Antagonists↗
PubMed1983

Vertebral bone loss: an unheeded side effect of therapeutic bed rest.

1. The skeletal effects of simple bed rest and re-ambulation were studied in a consecutive series of 34 patients (aged 18-60 years) hospitalized with low backache due to protrusion of a lumbar intervertebral disc. The bone mineral content of the second, third and fourth lumbar vertebrae was determined by dual-photon (153Gd) absorptiometry immediately after admission to the hospital, at the end of the bed-rest period (mean 27 days, range 11-61 days) and approximately 15 weeks later (range 11-24 weeks). 2. During recumbency a mean decrease in lumbar spine bone mineral content of 0.9% per week was observed. 3. Re-ambulation resulted in bone mineral gain, and restoration of lumbar spine bone mineral content was nearly complete after 4 months. 4. The findings suggest that the simple therapeutic bed-rest regimen leads to excessive vertebral bone loss. Recurrent bed-rest periods may predispose to spinal osteoporosis.

Adolescent↗
PubMed1997

Altered antioxidant enzyme defences in insulin-dependent diabetic men with increased resting and exercise-induced oxidative stress.

Impaired antioxidant defences may predispose to the increased resting and exercise-induced oxidative stress found in patients with insulin-dependent diabetes mellitus (IDDM). We investigated major erythrocyte antioxidant enzyme activities at rest and in response to sustained, moderate intensity physical exercise in young diabetic men (n = 9) previously reported to have markedly elevated plasma lipid peroxidation and blood glutathione levels compared with control men (n = 13) (Laaksonen et al. 1996). At rest, erythrocyte glutathione reductase activity was 15% higher in the diabetic group (P = 0.049). Se-glutathione peroxidase and glutathione-S-transferase activities were similar in both groups. Red cell Cu, Zn-superoxide dismutase and catalase activities were lower in the IDDM group (P = 0.033 and P = 0.023, respectively). After 40 min of exercise at 60% of the subjects' peak oxygen consumption, Se-glutathione peroxidase activity rose by about 14% in the control group (P = 0.003), but not in the IDDM group (P = 0.47). Exercise did not cause significant changes in other enzyme activities in either group. To conclude, lower erythrocyte Cu, Zn-superoxide dismutase and catalase activity in young men with IDDM at rest may contribute to increased oxidative stress. On the other hand, increased glutathione reductase activity may represent a compensatory upregulation of glutathione homeostasis in response to increased oxidative stress. Upregulation of Se-glutathione peroxidase activity in response to physical activity appeared to be impaired in men with IDDM.

Adult↗
PubMed1999

Body composition, resting and running metabolic rates, and net cost of running in rats during starvation.

Resting metabolic rate decreases during starvation. However, effects of starvation on the cost of running are not clear. The aim of this study was to examine the effects of 5 days starvation on body composition, resting metabolic rates, running metabolic rates, and net cost of running in male rats. Five days starvation resulted in reductions of 70% fat, 8% protein and 12% carbohydrates. Mass(-0.75) specific resting metabolic rate was significantly reduced from 3.69 +/- 0.27 to 2.73 +/- 0.17 W kg(-0.75) after 5 days starvation. The reduction in metabolic rate after 5 days starvation was maintained during running, in that running metabolic rate was reduced from 10.65 +/- 0.41 to 8.97 +/- 0.47 W kg(-0.75). The net costs of running were calculated and expressed as the costs of moving 1 kg a distance of 1 m. After 5 days of starvation it was reduced from 31.16 +/- 2.03-29.79 +/- 1.69 J m(-1) kg(-1). The reduction however was not significant. The present results therefore suggest that 5 days starvation resulted in a metabolic depression of the resting metabolic rate that was maintained during running. However, the net cost of running remained unchanged, suggesting that the muscle tissues are not significantly involved in the metabolic changes during starvation.

Animals↗
PubMed1999

Near-infrared monitoring of tissue oxygenation during application of lower body pressure at rest and during dynamical exercise in humans.

During the application of a wide range of graded lower body pressures (LBP) (-50 to 50 mmHg), we examined how (1) the tissue oxygenation in the lower and upper parts of the body changes at rest, and (2) how tissue oxygenation changes in the lower extremities during dynamical leg exercise. We used near-infrared spectroscopy (NIRS) to measure the changes induced by LBP in total Hb content and Hb oxygenation in seven subjects. At rest, total Hb increased and Hb oxygenation decreased in the thigh muscles during -25 and -50 mmHg LBP, while both decreased during +25 and +50 mmHg LBP. However, in the forearm muscles during graded LBP, the pattern of change in total Hb was the reverse of that in the thigh. Measurements from the forehead showed changes only during +50 mmHg LBP. These results demonstrated that the pattern of change in total Hb and Hb oxygenation differed between upper and lower parts with graded LBP at rest. During dynamical leg exercise, total Hb and Hb oxygenation in the thigh muscles decreased during stepwise increases in LBP above -25 mmHg, Hb oxygenation decreasing markedly during +50 mmHg LBP. These results suggest that during dynamical exercise (i) LBP at +25 mmHg or more causes a graded decline in blood volume and/or flow in the thigh muscles, and (ii) especially at +50 mmHg LBP, the O2 content may decrease markedly in active muscles. Our results suggest that NIRS can be used to monitor in a non-invasive and continuous fashion the changes in oxygenation occurring in human skeletal muscles and head during the graded changes in blood flow and/or volume caused by changes in external pressure and secondary reflexes both at rest and during dynamical exercise.

Adolescent↗
PubMed2001

Effects of rhythmic muscle compression on arterial blood pressure at rest and during dynamic exercise in humans.

This study was designed to examine the hypothesis that a rhythmic mechanical compression of muscles would affect systemic blood pressure regulation at rest and during dynamic exercise in humans. We measured the changes in mean arterial pressure (MAP) occurring (a) at rest with pulsed (350 ms pulses at 50 pulses min(-1)) or static compression (50 and 100 mmHg) of leg muscles with or without upper thigh occlusion, and (b) during 12-min supine bicycle exercise (75 W, 50 r.p.m.) with or without pulsed compression (50, 100, 150 mmHg) of the legs in synchrony with the thigh extensor muscle contraction. At rest with thigh occlusion, MAP increased by 4-8 mmHg during static leg compression, and by 5-9 mmHg during pulsed leg compression. This suggests that at rest pulsed leg compression elicits a reflex pressor response of similar magnitude to that evoked by static compression. During dynamic exercise without leg compression, MAP (having risen initially) gradually declined, but imposition of graded pulsed leg compression prevented this decline, the MAP values being significantly higher than those recorded without pulsed leg compression by 7-10 mmHg. These results suggest that the rhythmic increase in intramuscular pressure that occurs during dynamic exercise evokes a pressor response in humans.

Adult↗
PubMed1998

Effect of 20 days' bed rest on the reverse cholesterol transport system in healthy young subjects.

OBJECTIVES: To study the effects of 20 days of bed rest on HDL cholesterol, lipoprotein lipase, hepatic triglyceride lipase, cholesterol ester transfer protein and lecithin-cholesterol acyltransferase. DESIGN: A 20-day intervention study. SETTING: Makita general hospital. SUBJECTS: Five male and five female healthy participants, mean age 20.4 years, range 19-24 years. INTERVENTIONS: Twenty days of bed rest. MAIN OUTCOME MEASURES: Lipid, lipoprotein, lipoprotein lipase, hepatic triglyceride lipase, cholesterol ester transfer protein and lecithin-cholesterol acyltransferase. RESULTS: Fasting HDL, HDL2 and HDL3 cholesterol levels decreased from 1.748 to 1.404 mmol L(-1) (P < 0.01), from 0.807 to 0.628 mmol L(-1) (P < 0.01) and from 0.939 to 0.784 mmol L(-1) (P < 0.05), respectively, while VLDL triglyceride levels increased from 0.365 to 0.754 mmol L(-1) (P < 0.05). Plasma post-heparin lipoprotein lipase activity decreased from 0.494 to 0.418 micromol mL(-1) h(-1) (P < 0.01), but plasma post-heparin hepatic triglyceride lipase activity and cholesterol ester transfer protein activity did not change during bed rest. Lecithin-cholesterol acyltransferase activity increased from 72.5 to 84.8 nmol mL(-1) h(-1) (P < 0.001). CONCLUSIONS: Twenty days of bed rest induced a decline in HDL cholesterol levels and an increase in VLDL triglyceride levels. When considering lipoprotein lipase, hepatic triglyceride lipase, cholesterol ester transfer protein and lecithin-cholesterol acyltransferase as factors in the decreased HDL cholesterol, the contribution of lipoprotein lipase is suggested.

Adult↗
PubMed2003

Actigraphic assessment of the circadian rest-activity rhythm in elderly patients hospitalized in an acute care unit.

Hospitalization for acute illness is a major risk factor of rest-activity rhythm disturbance among elderly subjects. The rest-activity rhythm is disturbed by the acute illness, aging and hospital environment. The purpose of this study is to assess the rest-activity rhythm and light exposure (using a wrist worn actigraph) of 10 patients (mean age 81 years, seven females) admitted on an acute care unit, suffering from cardiac, respiratory or renal acute disease. A non-parametric method was used to analyze activity data. With an improvement of the underlying diseases, the mean relative amplitude of rhythm increased from 0.31 +/- 0.19 for the first 5-day period after admission to 0.54 +/- 0.21 for the second period before discharge (P < 0.05). The amount of time at night spent above a lighting threshold of 50 lux decreased from 31.4 to 12.3 min between the two periods. The rhythm of elderly subjects hospitalized in the acute care unit is severely altered during the initial period and is progressively resynchronized following clinical improvement. Under the acute underlying disease and/or aging, environmental conditions (light, noise) should be considered to maintain regular rest-activity rhythm.

Acute Disease↗
PubMed2003

Beat-to-beat measurement of the finger arterial pressure pulse shape index at rest and during exercise.

Arterial pressure waveform can be characterized by the pulse shape index kpulse determined as kpulse = (Pmean - Pdiast) / (Psyst - Pdiast). For brachial artery, the shape index value of 0.33 is usually applied to approximate Pmean from the measured Psyst and Pdiast. Our purpose was to test whether this value can validly be applied to finger vascular beds under different experimental conditions. By using Finapres, we non-invasively estimated the beat-to-beat values of kpulse in the fingers of young healthy persons in supine position at rest and during a 4-min moderate exercise (rhythmical exercise with the quadricep muscles in combination with handgrip compression). To detect intensive peripheral vasoconstrictions, a laser-Doppler probe was attached to the thumb pulp of the same hand. Periods of 30 s without intensive vasoconstriction for rest, different stages of exercise and recovery were involved in the analysis in every subject. The results demonstrated that the group-averaged value of kpulse (median with a 95% confidence interval) in the fingers of 11 healthy volunteers aged from 20 to 24, equalled 0.33 (0.31- 0.34), 0.31 (0.28-0.34), 0.35 (0.33-0.39) and 0.38 (0.34-0.43) for rest, first and second stages of exercise and recovery, respectively. We conclude that in the fingers of young healthy persons in supine position formula Pmean = Pdiast + 1/3 (Psyst - Pdiast) gives an adequate approximation for rest and low intensity exercise (first stage), and slightly underestimates the actual finger mean blood pressure during moderate exercise (second stage) and recovery.

Adult↗
PubMed2000

Fatigue during acute isovolemic anemiain healthy, resting humans.

BACKGROUND: Transfusion guidelines recommend that clinicians assess patients for signs and symptoms of anemia before the transfusion of RBCs. However, studies of signs and symptoms associated with acute isovolemic anemia are limited. The objective of this study was to determine whether acute reduction of Hb concentration to 5 g per dL would result in fatigue, tachycardia, or hypotension in resting, young, healthy, isovolemic humans, and whether changes were reversible with RBC transfusion. STUDY DESIGN AND METHODS: Conscious, resting, healthy adults less than 35 years old (n = 8) underwent acute isovolemic hemodilution to Hb of 5 g per dL and self-scored their energy level at various Hb concentrations. Heart rate and blood pressure were also measured. For controls, measurements of each subject were made during a comparable period of rest without hemodilution. RESULTS: During acute isovolemic hemodilution, energy levels decreased progressively and were lower at Hb of 7, 6, and 5 g per dL than at baseline (p<0.01) or in control sessions (p<0.05). The energy level was lower at Hb 7 g per dL than at 14 ( p = 0.005), lower at Hb 6 g per dL than at 7 (p = 0.01), and lower at Hb 5 g per dL than at 6 (p =0.01). Energy levels rose and were not different from baseline or control levels after transfusion of all autologous RBCs. Similarly, median heart rate increased with hemodilution to Hb of 7, 6, and 5 g per dL and decreased with transfusion of autologous RBCs. Supine blood pressure did not decrease with isovolemic hemodilution. CONCLUSION: In resting, young, healthy humans, acute isovolemic anemia to Hb levels of 7, 6, and 5 g per dL results in decreased self-scored energy levels and in an increase in heart rate but not in hypotension. Changes in energy and heart rate are reversible with the transfusion of autologous RBCs.

Acute Disease↗