Skip to main content
SpringerLink
Log in

Skin blood flow and autonomic reactivity in human poikilothermia

  • Research Paper
  • Published:
Clinical Autonomic Research Aims and scope Submit manuscript

Abstract

Autonomic reactivity is pivotal in maintaining a constant body core temperature. Skin vasomotor reflexes and cardiovascular reactivity were investigated in four women (aged 28–37 years) with acquired poikilothermia, during steady-state spontaneous hypothermia (rectal temperature (Tr)=33.7 ± 1.0°C [mean ±SD]) and steady-state normothermia (Tr=36.7 ± 0.3°C), as well as in 12 normothermic control subjects. Baseline finger temperature (Tf) during hypothermia was significantly lower than during normothermia (Tf=32.4 ± 1.2 compared with 36.2 ±0.3°C, respectively), and than in the controls (Tf=34.8 ±0.8°C). No significant differences in baseline skin blood flow and forearm blood flow were found between subjects during hypothermia or normothermia and controls, suggesting a failure of sympathetic drive to counter-regulate hypothermia in the subjects. Skin vasoconstrictor responses to the contralateral cooling test and neck cooling test were markedly attenuated in three subjects, and to the finger cooling test in two subjects, during normothermia compared with hypothermia. Blood presure responses to the Valsalva manoeuvre and head-up tilting were normal in all subjects, whereas the heart rate response to head-up tilting was blunted in three subjects during hypothermia. The responses of blood pressure and forearm blood flow to the cold pressor test in the subjects during both thermal conditions were comparable with the controls. We conclude that in our subjects, without generalized autonomic failure, poikilothermia has to be attributed predominantly to disorders of the central thermoregulatory pathways. Our findings during hypothermia and normothermia indicate that variations in core and skin temperature significantly affect skin vasomotor reactivity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Rowell LB. Cardiovascular aspects of human thermoregulation.Circ Res 1983;52: 367–379.

    Google Scholar 

  2. Johnson JM. Nonthermoregulatory control of human skin blood flow.J Appl Physiol 1986;61: 613–622.

    Google Scholar 

  3. Collins KJ. The autonomic nervous system and the regulation of body temperature. In: Bannister R, Mathias CJ, eds.Autonomic Failure. 3rd edn. Oxford: Oxford University Press, 1992; 212–230.

    Google Scholar 

  4. Hensel H. Neural processes in thermoregulation.Physiol Rev 1973;53: 948–1017.

    Google Scholar 

  5. Plum F, van Uitert R. Nonendocrine diseases and disorders of the hypothalamus. In: Reichlin S, Baldessarini RJ, Martin JB, eds.The Hypothalamus. New York: Raven Press, 1978; 415–473.

    Google Scholar 

  6. Wyss CR, Brengelman GL, Johnson JM, Rowell LB, Silverstein D. Altered control of skin blood flow at high skin and core temperatures.J Appl Physiol 1975;38: 839–845.

    Google Scholar 

  7. Ogawa T, Low PA. Autonomic regulation of temperature and sweating. In: Low PA, ed.Clinical Autonomic Disorders. Boston: Little, Brown and Company, 1993; 79–91.

    Google Scholar 

  8. Rowell LB. Human cardiovascular adjustments to exercise and thermal stress.Physiol Rev 1974;54: 75–159.

    Google Scholar 

  9. Fox RH, Davies TW, Marsh FP, Urich H. Hypothermia in a young man with an anterior hypothalamic lesion.Lancet 1970; ii: 185–188.

    Google Scholar 

  10. Robbins AS. Hypothermia and heat stroke: protecting the elderly patient.Geriatrics 1989;44: 73–80.

    Google Scholar 

  11. Ivanov KP, Eremyagin AI. The special role of the hands in human thermoregulation.Fiziol Zh SSSR 1973;59: 1624–1628.

    Google Scholar 

  12. MacKenzie MA, Hermus ARMM, Wollersheim HCH et al. Poikilothermia in man: pathophysiology and clinical implications.Medicine (Baltimore) 1991;70: 257–268.

    Google Scholar 

  13. MacKenzie MA, Hermus ARMM, Wollersheim HCH, Binkhorst RA, Pieters GFFM. Thermoregulation and afterdrop during hypothermia in patients with poikilothermia.Q J Med 1993;86: 205–213.

    Google Scholar 

  14. Cleophas AJM, Fennis JFM, van't Laar A. Finger temperature after a finger cooling test: influence of air temperature and smoking.J Appl Physiol 1982;52: 1167–1171.

    Google Scholar 

  15. Fagius J, Blumberg H. Sympathetic outflow to the hand in patients with Raynaud's phenomenon.Cardiovasc Res 1985;19: 249–253.

    Google Scholar 

  16. Low P, Neumann C, Dyck PJ, Fealy RD, Tuck RR. Evaluation of skin vasomotor reflexes by using laser Doppler velocimetry.Mayo Clin Proc 1983;58: 583–592.

    Google Scholar 

  17. Mathias CJ, Bannister R. Investigation of autonomic disorders. In: Bannister R, Mathias CJ, eds.Autonomic Failure. 3rd edn. Oxford: Oxford University Press, 1992; 255–290.

    Google Scholar 

  18. Netten PM, Boots JMM, Bredie SJH et al. An automated computerized method using Finapress for measuring cardiovascular reflexes.Clin Sci 1992;83: 157–163.

    Google Scholar 

  19. Chernow B, Lake R, Zaritsky A et al. Sympathetic nervous system ‘switch off’ with severe hypothermia.Crit Care Med 1983;11: 677–680.

    Google Scholar 

  20. MacKenzie MA, Aengevaeren WRM, Hermus ARMM et al. Electrocardiographic changes during steady mild hypothermia and normothermia in patients with poikilothermia.Clin Sci 1992;82: 39–45.

    Google Scholar 

  21. Eliasson K, Hjemdahl P, Kahan T. Circulatory and sympathoadrenal responses to stress in borderline and established hypertension.J Hypertens 1983;1: 131–139.

    Google Scholar 

  22. Wollersheim H, Droste H, Reyenga J, Thien Th. Laser Doppler evaluation of skin vasomotor reflexes during sympathetic stimulation in normals and in patients with Raynaud's phenomenon.Int J Microcirc Clin Exp 1991;10: 33–42.

    Google Scholar 

  23. Rowell LB, Brengelmann GL, Detry J-MR, Wyss C. Venomotor responses to rapid changes in skin temperature in exercising man.J Appl Physiol 1971;30: 64–71.

    Google Scholar 

  24. Rowell LB, Brengelmann GL, Detry J-MR, Wyss C. Venomotor responses to local and remote thermal stimuli to skin in exercising man.J Appl Physiol 1971;30: 72–77.

    Google Scholar 

  25. Zitnik RS, Ambrosioni E, Shepherd JT. Effect of temperature on cutaneous venomotor reflexes in man.J Appl Physiol 1971;31: 507–512.

    Google Scholar 

  26. Kahn EA. Postoperative loss of temperature control — poikilothermia.J Neurosurg 1958;15: 329–337.

    Google Scholar 

  27. Hockaday TDR, Cranston WI, Cooper KE, Mottram RF. Temperature regulation in chronic hypothermia.Lancet 1962; ii: 428–432.

    Google Scholar 

  28. Bannister R. The classification and causes of heat illness. D. M. Thesis, University of Oxford, 1963.

  29. Cross KW, Hey EN, Kennaird DL, Lewis SR, Urich H. Lack of temperature control in infants with abnormalities of central nervous system.Arch Dis Child 1971;46: 437–443.

    Google Scholar 

  30. Lipton JM, Payne H, Garza HR, Rosenberg RN. Thermolability in Wernicke's encephalopathy.Arch Neurol 1978;35: 750–753.

    Google Scholar 

  31. Kregel KC, Johnson DG, Tipton CM, Seals DR. Arterial baroreceptor reflex modulation of sympathetic-cardiovascular adjustments to heat stress.Hypertension 1990;15: 497–504.

    Google Scholar 

  32. Johnson RH, Park DM. Intermittent hypothermia: Independence of central and reflex thermoregulatory mechanisms.J Neurol Neurosurg Psychiat 1973;36: 411–416.

    Google Scholar 

  33. Johnson RH, Delahunt JW, Robinson BJ. Do thermoregulatory reflexes pass through the hypothalamus? — studies of chronic hypothermia due to hypothalamic lesion.Aust NZ J Med 1990;20: 154–159.

    Google Scholar 

  34. MacKenzie MA, Schönbaum E, Hermus ARMM et al. Sudomotor function in human poikilothermia.Neurology 1995;45: 1602–1607.

    Google Scholar 

  35. Goodman EL, Knochel JP. Heat stroke and other forms of hyperthermia. In: Mackowiak PA, ed.Fever: Basic Mechanisms and Management. New York: Raven Press, 1991; 267–287.

    Google Scholar 

  36. MacKenzie MA. Poikilothermia in man. In: Mackowiak PA, ed.Fever: Basic Mechanisms and Management. 2nd edn. New York: Raven Press, 1996; in press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Division of General Internal Medicine, University Hospital Nijmegen, The Netherlands

    M. A. MacKenzie MD, H. C. H. Wollersheim MD, J. W. M. Lenders MD & T. Thien MD

  2. Department of Medicine, Division of Endocrinology, University Hospital Nijmegen, PO Box 9101, 6500 HB, Nijmegen, The Netherlands

    M. A. MacKenzie MD & A. R. M. M. Hermus MD

Authors
  1. M. A. MacKenzie MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. C. H. Wollersheim MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. W. M. Lenders MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. R. M. M. Hermus MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. Thien MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

MacKenzie, M.A., Wollersheim, H.C.H., Lenders, J.W.M. et al. Skin blood flow and autonomic reactivity in human poikilothermia. Clinical Autonomic Research 6, 91–97 (1996). https://doi.org/10.1007/BF02291229

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02291229

Key words

Search

Navigation