Characterization of Arterial Pressure and Cerebral Blood Flow Responses To Repeated Thigh Cuff Inflation In Three Experimental Models (Humans, Pigs, Rats)

In a human model of simulated blood loss, oscillatory patterns of arterial pressure and blood flow, or "pulsatile perfusion", can protect cerebral and peripheral tissue oxygenation, and prolong tolerance to this stress. In this pilot study, we characterize the hemodynamic responses to pulsatile perfusion therapy induced via repeated thigh cuff inflations in humans at rest, and in pig and rat models of actual blood loss. In 2 human participants, 0.1 Hz (10-second cycle) thigh cuff oscillations induced robust 0.1 Hz oscillations in arterial pressure and cerebral blood flow. In the two animal models, all subjects underwent a baseline period, hemorrhage of 55% of total blood volume, then a 30-min period with or without thigh cuff oscillations (0.1 Hz for pigs, and 0.5 Hz for rats). Decreases in mean arterial pressure (MAP) and carotid artery blood flow were observed in response to hemorrhage (P≤0.002) in both pigs and rats. At the end of the PPT period, however, no differences were observed between the oscillation or no oscillation groups for absolute MAP (rats, P=0.44; pigs, P=0.90) or common carotid artery (CCA) peak blood flow (rats, P=0.92; pigs, P=0.93). When examining the frequency power spectrums, there was not a robust increase in 0.5 Hz oscillations for MAP (P=0.23) or CCA flow (P=0.82), but 0.1 Hz oscillations were detected in CCA flow for pigs (P=0.09). While in the human model, large increases in oscillatory power were observed for both arterial pressure and cerebral blood flow, the responses in the two animal models were inconclusive due to high inter-individual variability. These findings indicate the need for further studies and refinement of the thigh cuff approach in the animal models to reliably induce hemodynamic oscillations.