Comparison of saline and fludrocortisone as fluid-loading countermeasures following exposure to simulated microgravity

摘要

Saline loading (SL) within hours of reentry is currently used as a countermeasure against postflight orthostatic hypotension in astronauts. However, its effects on blood volume expansion is not quantified and its effectiveness has proved marginal at best. The purposes of the present study were: (1) to quantify the effects of SL on plasma volume and orthostatic tolerance following exposure to simulated microgravity and (2) to compare these effects with the use of a pharacological fluid expander, fludrcortisone (F). Method: Eleven men (30-45 yr.) underwent a 15-minute stand test before and immediately after 7 days of head-down bedrest (BR). Five subjects ingested SL (8 g salt tablets with 1 liter of water) 2 hours before standing at the end of BR while the other 6 subjects received 0.2 mg oral doses of F at 0800 and 2200 hours the day before and 0800 hours the day the subjects got out of bed (i.e., 2 hours before standing). Plasma volume (PV) was measured before BR on day 7 of BR and after the final SL and F treatments just before the post-BR stand test. Blood pressure and heart rate were measured continuously during the stand tests. Results: BR decreased PV from 40.7 plus or minus 1.9 mml/kg to 35.9 plus or minus 1.1 ml/kg (minus 11.8 percent P less than 0.05). Following SL, PV remained at 36.4 plus or minus 1.5 ml/kg while F returned PV to 39.1 plus or minus 1.8 ml/kg. The post BR stand test was completed without syncopal symptoms by 5 of 6 F subjects but only 2 of 5 SL subjects. Conclusions: SL may be ineffective in restoring PV to preflight levels and may provide inadequate protection against postflight orthostatic hypotension. In contrast, F may provide a promising countermeasure since it restored PV and reduced the incidence of syncope following exposure to simulated microgravity in the present study.