Cross-sectional areas of deep/core veins are smaller at lower core body temperatures

Heat-related changes in the velocity and kinetic energy of flowing blood influence the human heart's output during hyperthermia

Passive whole-body hyperthermia increases limb blood flow and cardiac output (Q ̇ $\dot Q$ ), but the interplay between peripheral and central thermo-haemodynamic mechanisms remains unclear. Here we tested the hypothesis that local hyperthermia-induced alterations in peripheral blood flow and blood kinetic energy modulate flow to the heart andQ ̇ $\dot Q$ . Body temperatures, regional (leg, arm, head) and systemic haemodynamics, and left ventricular (LV) volumes and functions were assessed in eight healthy males during: (1) 3 h control (normothermic condition); (2) 3 h of single-leg heating; (3) 3 h of two-leg heating; and (4) 2.5 h of whole-body heating. Leg, forearm, and extracranial blood flow increased in close association with local rises in temperature while brain perfusion remained unchanged. Increases in blood velocity with small to no changes in the conduit artery diameter underpinned the augmented limb and extracranial perfusion. In all heating conditions,Q ̇ $\dot Q$ increased in association with proportional elevations in systemic vascular conductance, related to enhanced blood flow, blood velocity, vascular conductance and kinetic energy in the limbs and head (all R2 ≥ 0.803; P < 0.001), but not in the brain. LV systolic (end-systolic elastance and twist) and diastolic functional profiles (untwisting rate), pulmonary ventilation and systemic aerobic metabolism were only altered in whole-body heating. These findings substantiate the idea that local hyperthermia-induced selective alterations in peripheral blood flow modulate the magnitude of flow to the heart andQ ̇ $\dot Q$ through changes in blood velocity and kinetic energy. Localised heat-activated events in the peripheral circulation therefore affect the human heart's output. KEY POINTS: Local and whole-body hyperthermia increases limb and systemic perfusion, but the underlying peripheral and central heat-sensitive mechanisms are not fully established. Here we investigated the regional (leg, arm and head) and systemic haemodynamics (cardiac output:Q ̇ $\dot Q$ ) during passive single-leg, two-leg and whole-body hyperthermia to determine the contribution of peripheral and central thermosensitive factors in the control of human circulation. Single-leg, two-leg, and whole-body hyperthermia induced graded increases in leg blood flow andQ ̇ $\dot Q$ . Brain blood flow, however, remained unchanged in all conditions. Ventilation, extracranial blood flow and cardiac systolic and diastolic functions only increased during whole-body hyperthermia. The augmentedQ ̇ $\dot Q$ with hyperthermia was tightly related to increased limb and head blood velocity, flow and kinetic energy. The findings indicate that local thermosensitive mechanisms modulate regional blood velocity, flow and kinetic energy, thereby controlling the magnitude of flow to the heart and thus the coupling of peripheral and central circulation during hyperthermia.

Hemodynamic response to thermal stress varies with sex and age: a murine MRI study

PURPOSE

The cardiovascular (CV) system plays a vital role in thermoregulation because of its influence on heat transfer via forced convection and conduction by changes in blood distribution, blood velocity, and proximity of vessels to surrounding tissues. To fully understand the cardiovascular system's role in thermoregulation, blood distribution (influenced by cardiac output, vessel size, blood flow, and pressure) must be quantified, ideally across sex and age. Additionally, wall shear stress is quantified because it is an important metric in cardiovascular disease localization and progression. By investigating the effect of thermal conditions on wall shear stress at a healthy baseline, researchers can begin to study the confluence of thermal condition with pathology or exercise. The purpose of this study is to determine the influence of sex and age on the CV response to temperature. In this work, the effect of core body temperature on hemodynamics of the murine arterial and venous systems has been studied non-invasively, at multiple locations across age and sex.

METHODS

Male and female, adult and aged, mice (n = 20) were anesthetized and underwent MRI at 7 T. Data were acquired from four co-localized vessel pairs (the neck [carotid/jugular], torso [suprarenal and infrarenal aorta/inferior vena cava (IVC)], periphery [femoral artery/vein]) at core temperatures of 35, 36, 37, and 38 °C. Sixteen CINE, ECG-gated, phase contrast frames with one-directional velocity encoding (through plane) were acquired perpendicular to each vessel. Each frame was analyzed to quantify blood velocity and volumetric flow using a semi-automated in-house MATLAB script. Wall shear stress (WSS) was calculated using the Hagen-Poiseulle formula. A multivariable regression for WSS in the femoral artery was fitted with temperature, sex, age, body weight, and heart rate as variables.

RESULTS

Blood velocity and volumetric flow were quantified in eight vessels at four core body temperatures. Flow in the infrarenal IVC linearly increased with temperature for all groups (p = .002; adjusted means of slopes: male vs. female, 0.37 and 0.28 cm/(s × °C); adult vs. aged, 0.22 and 0.43 cm/(s × °C)). Comparing average volumetric flow response to temperature, groups differed for the suprarenal aorta (adult < aged, p < .05), femoral artery (adult < aged, p < .05), and femoral vein (adult male < aged male, p < .001). The two-way interaction terms of temperature and body weight and temperature and sex had the largest effect on wall shear stress.

CONCLUSIONS

Age, in particular, had a significant impact on hemodynamic response as measured by volumetric flow (e.g., aged males > adult males) and WSS at peak-systole (e.g., aged males < adult males). The hemodynamic data can provide physiologically-relevant parameters, including sex and age difference, to computational fluid dynamics models and provide baseline data for the healthy murine vasculature to use as a benchmark for investigations of a variety of physiological (thermal stress) and pathophysiological conditions of the cardiovascular system.

Effect of topical application of black pepper essential oil on peripheral intravenous catheter insertion: A randomized controlled study

OBJECTIVE

The literature describes many techniques to increase vein visibility and palpability that facilitate peripheral intravenous catheter insertion. However, there is only one study examining the effect of topical essential black pepper oil on veins. We aimed to determine the effects of topical application of black pepper essential oil on peripheral intravenous catheter insertion success.

METHODS

This randomized controlled trial was carried out on 60 patients randomly assigned to either the experimental group (n=30) or the control group (n=30) reporting to the endoscopy unit of the clinic between May 2019 and October 2019. The study results were evaluated using an information form, a catheter insertion form, and a visual analog scale (VAS). In the experimental group, black pepper essential oil was used to increase vein degree before the procedure, while in the control group, no extra interventions were applied. The time taken in determining an appropriate vein, time taken for successful catheter insertion, and the patient's and nurse's satisfaction after the process were recorded.

RESULTS

Significant improvements in vein degree were detected after the experimental group's oil application (p₁<0.001). The period of appropriate vein selection and successful catheter insertion showed a statistically significant decrease in the experimental group (p<0.05). The satisfaction levels of patients and nurses in the control group were significantly lower than those of the patients from the experimental group (p<0.05).

CONCLUSION

Topical black pepper oil application can increase the vein degree and the success of the procedure.

In Vivo MRI Assessment of Blood Flow in Arteries and Veins from Head-to-Toe Across Age and Sex in C57BL/6 Mice

Although widely used as a preclinical model for studying cardiovascular diseases, there is a scarcity of in vivo hemodynamic measurements of the naïve murine system in multiple arterial and venous locations, from head-to-toe, and across sex and age. The purpose of this study is to quantify cardiovascular hemodynamics in mice at different locations along the vascular tree while evaluating the effects of sex and age. Male and female, adult and aged mice were anesthetized and underwent magnetic resonance imaging. Data were acquired from four co-localized vessel pairs (carotid/jugular, suprarenal and infrarenal aorta/inferior vena cava (IVC), femoral artery/vein) at normothermia (core temperature 37 ± 0.2 °C). Influences of age and sex on average velocity differ by location in arteries. Average arterial velocities, when plotted as a function of distance from the heart, decrease nearly linearly from the suprarenal aorta to the femoral artery (adult and aged males: - 0.33 ± 0.13, R²= 0.87; - 0.43 ± 0.10, R² = 0.95; adult and aged females: - 0.23 ± 0.07, R² = 0.91; - 0.23 ± 0.02, R² = 0.99). Average velocity of aged males and average volumetric flow of aged males and females tended to be larger compared to adult comparators. With cardiovascular disease as the leading cause of death and with the implications of cardiovascular hemodynamics as important biomarkers for health and disease, this work provides a foundation for sex and age comparisons in pathophysiology by collecting and analyzing hemodynamic data for the healthy murine arterial and venous system from head-to-toe, across sex and age.

Assessing structural and functional response of murine vasculature to acute β-adrenergic stimulation in vivo during hypothermic and hyperthermic conditions

Background: Because of the importance of adrenoreceptors in regulating the cardiovascular (CV) system and the role of the CV system in thermoregulation, understanding the response to these two stressors is of interest. The purpose of this study was to assess changes of arterial geometry and function in vivo during thermal and β-adrenergic stress induced in mice and quantified by MRI.Methods: Male mice were anesthetized and imaged at 7 T. Anatomical and functional data were acquired from the neck (carotid artery), torso (suprarenal and infrarenal aorta and iliac artery) and periphery (femoral artery). Intravenous dobutamine (tail vein catheter, 40 µg/kg/min, 0.12 mL/h) was used as β-adrenergic stressor. Baseline and dobutamine data were acquired at minimally hypothermic (35 °C) and minimally hyperthermic (38 °C) core temperatures. Cross-sectional vessel area and maximum cyclic strain were measured across the cardiac cycle.Results: Vascular response varied by location and by core temperature. For minimally hypothermic conditions (35 °C), average, maximum and minimum areas decreased with dobutamine only at the suprarenal aorta (avg: -17.9%, max: -13.5%, min: -21.4%). For minimally hyperthermic conditions (38 °C), vessel areas decreased between baseline and dobutamine at the carotid (avg: -19.6%, max: -15.5%, min: -19.3%) and suprarenal aorta (avg: -24.2%, max: -17.4%, min: -17.3%); whereas, only the minimum vessel area decreased for the iliac artery (min: -14.4%). Maximum cyclic strain increased between baseline and dobutamine at the iliac artery for both conditions and at the suprarenal aorta at hyperthermic conditions.Conclusions: At hypothermic conditions, the vessel area response to dobutamine is diminished compared to hyperthermic conditions where the vessel area response mimics normothermic dobutamine conditions. The varied response emphasizes the need to monitor and control body temperature during medical conditions or treatments that may be accompanied by hypothermia, especially when vasoactive agents are used.