ArticleClinical autonomic research : official journal of the Clinical Autonomic Research Society2015
Postural change in volunteers: sympathetic tone determines microvascular response to cardiac preload and output increases.
Article in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Peripheral skin cooling during gravitational challenges in parabolic flight - experimental protocol, implementation, and case study of the CoolFly experiment.Frontiers in physiology · 2025Article
- Article
- Comparison of sublingual microcirculatory parameters measured by sidestream darkfield videomicroscopy in anesthetized pigs and adult humans.Animal models and experimental medicine · 2023Article
- Upright versus supine MRI: effects of body position on craniocervical CSF flow.Fluids and barriers of the CNS · 2021Article
- Body Position Affects Capillary Blood Flow Regulation Measured with Wearable Blood Flow Sensors.Diagnostics (Basel, Switzerland) · 2021Article
- Capillary refill time variation induced by passive leg raising predicts capillary refill time response to volume expansion.Critical care (London, England) · 2019Observational
- Passive Leg Raising in Intensive Care Medicine.Chinese medical journal · 2016Review
Corrections and comments
- Erratum issued
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMicrovascular perfusion may be a non-invasive indicator of fluid responsiveness. We aimed to investigate which of the microvascular perfusion parameters truly reflects fluid responsiveness independent of sympathetic reflexes.
methodsFifteen healthy volunteers underwent a postural change from head up tilt (HUT) to the supine position, diminishing sympathetic tone, followed by a 30° passive leg raising (PLR) with unaltered tone. Prior to and after the postural changes, stroke volume (SV) and cardiac output (CO) were measured, as well as sublingual microcirculatory perfusion (sidestream dark field imaging), skin perfusion, and oxygenation (laser Doppler flowmetry and reflectance spectroscopy).
resultsIn responders (subjects with >10 % increase in CO), the HUT to supine change increased CO, SV, and pulse pressure, while heart rate, systemic vascular resistance, and mean arterial pressure decreased. Additionally, microvascular flow index, laser Doppler flow, and microvascular hemoglobin oxygen saturation and concentration also increased.
conclusionWhen preload and forward flow increase in association with a decrease in sympathetic activity, microvascular blood flow increases in the skin and in the sublingual area. When preload and forward flow increase with little to no change in sympathetic activity, only sublingual functional capillary density increases. Therefore, our results indicate that sublingual functional capillary density is the best parameter to use when evaluating fluid responsiveness independent of changes in sympathetic tone.
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