Head-up tilt to 45 degrees increased plasma noradrenaline by 14% in tetraplegic patients compared to 115% in normal controls, indicating a failure of sympathetic activity in tetraplegia.
Observational (n=9)
Does head-up tilt alter plasma catecholamines, renin activity, and aldosterone differently in tetraplegic patients compared to normal subjects?
Tetraplegic patients show a blunted sympathetic response but an exaggerated renin-aldosterone response during head-up tilt.
Tasa de eventos absoluta: 14% vs 115%
Plasma catecholamines, plasma renin activity, plasma aldosterone and haematocrit were measured in four subjects with physiologically complete cervical spinal cord transections, before, during and after head-up tilt to 45 degrees for 30 min. Plasma catecholamines were measured in five normal male volunteers in the supine position and after head-up tilt to 45 degrees for 10 min. 2. After 10 min of head-up tilt, the plasma noradrenaline rose 14% in the tetraplegic patients and 115% in the control subjects. These findings indicate a failure of sympathetic activity in response to head-up tilt in the tetraplegic patients, probably caused by interruption of pathways by which the brain normally controls sympathetic outflow. 3. In the tetraplegic patients the resting plasma renin activities were above normal, and rose more quickly and greater on head-up tilt than in published studies of normal subjects. It is likely that the renal baroreceptors are important in the control of renin release. 4. In the tetraplegic patients, there was a late rise in plasma aldosterone which was probably due to the elevation in plasma renin activity.
Mathias et al. (Wed,) conducted a observational in Tetraplegia (n=9). Head-up tilt to 45 degrees vs. Normal male volunteers was evaluated on Plasma noradrenaline rise after 10 min of head-up tilt. Head-up tilt to 45 degrees increased plasma noradrenaline by 14% in tetraplegic patients compared to 115% in normal controls, indicating a failure of sympathetic activity in tetraplegia.
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