Human cardiorespiratory and cerebrovascular function during severe passive hyperthermia: effects of mild hypohydration

The influence of severe passive heat stress and hypohydration ( Hypo) on cardiorespiratory and cerebrovascular function is not known. We hypothesized that 1) heating-induced hypocapnia and peripheral redistribution of cardiac output (Q.) would compromise blood flow velocity in the middle cerebral artery (MCAv) and cerebral oxygenation; 2) Hypo would exacerbate the hyperthermic-induced hypocapnia, further decreasing MCAv; and 3) heating would reduce MCAv-CO2 reactivity, thereby altering ventilation. Ten men, resting supine in a water-perfused suit, underwent progressive hyperthermia [0.5 degrees C increments in core (esophageal) temperature (T-C) to + 2 degrees C] while euhydrated (Euh) or Hypo by 1.5% body mass (attained previous evening). Time-control (i.e., non-heat stressed) data were obtained on six of these subjects. Cerebral oxygenation ( near-infrared spectroscopy), MCAv, end-tidal carbon dioxide (PETCO2) and arterial blood pressure, Q. ( flow model), and brachial and carotid blood flows (CCA) were measured continuously each 0.5 degrees C change in TC. At each level, hypercapnia was achieved through 3-min administrations of 5% CO2, and hypocapnia was achieved with controlled hyperventilation. At baseline in Hypo, heart rate, MCAv and CCA were elevated (P < 0.05 vs. Euh). MCAv-CO2 reactivity was unchanged in both groups at all TC levels. Independent of hydration, hyperthermic-induced hyperventilation caused a severe drop in PETCO2 (- 8 +/- 1 mmHg/degrees C), which was related to lower MCAv (-15 +/- 3%/degrees C; R-2 = 0.98; P < 0.001). Elevations in Q. were related to increases in brachial blood flow (R-2 = 0.65; P < 0.01) and reductions in MCAv (R-2 = 0.70; P < 0.01), reflecting peripheral distribution of Q.. Cerebral oxygenation was maintained, presumably via enhanced O-2-extraction or regional differences in cerebral perfusion.