Key result
Drinking 200 mL of water and rapid saline infusion reversed hyperosmolality-induced suppression of skin sympathetic nerve activity, enhancing cutaneous vasodilatation and sweating in hyperthermia.
Why the study?
Does drinking water or rapid saline infusion enhance skin sympathetic nerve activity components in hyperthermic and hypovolaemic humans?
Does drinking water or rapid saline infusion enhance skin sympathetic nerve activity components in hyperthermic and hypovolaemic humans?
Oropharyngeal stimulation via drinking and rapid saline infusion can reverse the suppression of skin sympathetic nerve activity components caused by hyperosmolality and hypovolaemia during hyperthermia.
May inform fluid strategies in hyperthermia; leaves open clinical translation and outcomes in patients.
Key points In hyperthermia, plasma hyperosmolality suppresses both cutaneous vasodilatation and sweating responses and this suppression is removed by oropharyngeal stimulation such as drinking. Hypovolaemia suppresses only cutaneous vasodilatation, which is enhanced by rapid infusion in hyperthermia. Our recent studies suggested that skin sympathetic nerve activity (SSNA) involves components synchronized and non‐synchronized with the cardiac cycle, which are associated with an active vasodilator and a sudomotor, respectively. In the present study, plasma hyperosmolality suppressed both components; drinking removed the hyperosmolality‐induced suppressions, simultaneously with increases in cutaneous vasodilatation and sweating, while not altering plasma volume and osmolality. Furthermore, a rapid saline infusion increased the synchronized component and cutaneous vasodilatation in hypovolaemic and hyperthermic humans. The results support our idea that SSNA involves an active cutaneous vasodilator and a sudomotor, and that a site where osmolality signals are projected to control thermoregulation is located more superior than the medulla where signals from baroreceptors are projected. Abstract We reported that skin sympathetic nerve activity (SSNA) involved components synchronized and non‐synchronized with the cardiac cycle; both components increased in hyperthermia and our results suggested that the components are associated with an active vasodilator and a sudomotor, respectively. In the present study, we examined whether the increases in the components in hyperthermia would be suppressed by plasma hyperosmolality simultaneously with suppression of cutaneous vasodilatation and sweating and whether this suppression was released by oropharyngeal stimulation (drinking). Also, effects of a rapid saline infusion on both components and responses of cutaneous vasodilatation and sweating were tested in hypovolaemic and hyperthermic subjects. We found that (1) plasma hyperosmolality suppressed both components in hyperthermia, (2) the suppression was released by drinking 200 mL of water simultaneously with enhanced cutaneous vasodilatation and sweating responses, and (3) a rapid infusion at 1.0 and 0.2 ml min −1 kg −1 for the first 10 min and the following 20 min, respectively, increased the synchronized component and cutaneous vasodilatation in diuretic‐induced hypovolaemia greater than those in a time control; at 0.1 ml min −1 kg −1 for 30 min no greater increases in the non‐synchronized component and sweating responses were observed during rapid infusion than in the time control. The results support the idea that SSNA involves components synchronized and non‐synchronized with the cardiac cycle, associated with the active cutaneous vasodilator and sudomotor, and a site of osmolality‐induced modulation for thermoregulation is located superior to the medulla where signals from baroreceptors are projected.
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Kamijo et al. (2018) studied Hyperthermia, hypovolaemia, and hyperosmolality. Drinking water and rapid saline infusion vs. Time control was evaluated on Skin sympathetic nerve activity (SSNA) components, cutaneous vasodilatation, and sweating. Drinking 200 mL of water and rapid saline infusion reversed hyperosmolality-induced suppression of skin sympathetic nerve activity, enhancing cutaneous vasodilatation and sweating in hyperthermia.
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