Research Article | Open Access
Daniel Vena, Babak Taati, Azadeh Yadollahi, "Predicting Neck Fluid Accumulation While Supine", Journal of Healthcare Engineering, vol. 6, Article ID 782545, 18 pages, 2015. https://doi.org/10.1260/2040-2222.214.171.1243
Predicting Neck Fluid Accumulation While Supine
When lying supine, fluid shifts rostrally from the legs and accumulates in the neck, which is a risk factor for obstructive sleep apnea. The objective of this study was to model neck fluid accumulation using one-time baseline measurements of body fluid, demographics, and anthropometrics. Using bioelectrical impedance, leg and neck fluid volumes (LFV and NFV) were measured continuously and simultaneously. Thirty non-obese adults (13 men) stood quietly for 5 minutes, and then lay supine for 90 minutes while fluid volumes were measured. Neck circumference (NC) was measured before and after the supine period. Results demonstrated that, compared to women, men experienced a greater increase in NC after lying supine. Furthermore, baseline LFV at the onset of lying supine was significantly correlated with ΔLFV (r = 0.44, p = 0.014) and ΔNC (r = 0.51, p = 0.008) after 90 minutes supine. The findings identify that sex and baseline LFV predict both the fluid leaving the legs and increase in NC during recumbency.
- K. L. Chiu, C. M. Ryan, S. Shiota et al., “Fluid shift by lower body positive pressure increases pharyngeal resistance in healthy subjects,” Am. J. Respir. Crit. Care Med., vol. 174, no. 12, pp. 1378–1383, 2006.
- S. Redolfi, D. Yumino, P. Ruttanaumpawan et al., “Relationship between overnight rostral fluid shift and Obstructive Sleep Apnea in nonobese men,” Am. J. Respir. Crit. Care Med., vol. 179, no. 3, pp. 241–246, 2009.
- S. Shiota, C. M. Ryan, K. L. Chiu et al., “Alterations in upper airway cross-sectional area in response to lower body positive pressure in healthy subjects,” Thorax, vol. 62, no. 10, pp. 868–872, 2007.
- M. C. Su, K. L. Chiu, P. Ruttanaumpawan et al., “Lower body positive pressure increases upper airway collapsibility in healthy subjects,” Respir Physiol Neurobiol, vol. 161, no. 3, pp. 306–312, 2008.
- O. Friedman, T. D. Bradley, and A. G. Logan, “Influence of lower body positive pressure on upper airway cross-sectional area in drug-resistant hypertension,” Hypertension, vol. 61, no. 1, pp. 240–245, 2013.
- J. W. Shepard, D. A. Pevernagie, A. W. Stanson, B. K. Daniels, and P. F. Sheedy, “Effects of changes in central venous pressure on upper airway size in patients with obstructive sleep apnea,” Am. J. Respir. Crit. Care Med., vol. 153, no. 1, pp. 250–254, 1996.
- T. Kasai, S. S. Motwani, D. Yumino et al., “Contrasting effects of lower body positive pressure on upper airways resistance and partial pressure of carbon dioxide in men with heart failure and obstructive or central sleep apnea,” J. Am. Coll. Cardiol., vol. 61, no. 11, pp. 1157–1166, 2013.
- M. C. Su, K. L. Chiu, P. Ruttanaumpawan et al., “Difference in upper airway collapsibility during wakefulness between men and women in response to lower-body positive pressure,” Clin. Sci., vol. 116, no. 9, pp. 713–720, 2009.
- L. H. White and T. D. Bradley, “Role of nocturnal rostral fluid shift in the pathogenesis of obstructive and central sleep apnoea,” J. Physiol. (Lond.), vol. 591, no. 5, pp. 1179–1193, 2013.
- O. Friedman, T. D. Bradley, C. T. Chan, R. Parkes, and A. G. Logan, “Relationship between overnight rostral fluid shift and obstructive sleep apnea in drug-resistant hypertension,” Hypertension, vol. 56, no. 6, pp. 1077–1082, 2010.
- T. Kasai, S. S. Motwani, D. Yumino, S. Mak, G. E. Newton, and T. D. Bradley, “Differing relationship of nocturnal fluid shifts to sleep apnea in men and women with heart failure,” Circ Heart Fail, vol. 5, no. 4, pp. 467–474, 2012.
- E. H. Starling, “On the Absorption of Fluids from the Connective Tissue Spaces,” J. Physiol. (Lond.), vol. 19, no. 4, pp. 312–326, 1986.
- A. Krogh, E. M. Landis, and A. H. Turner, “The movement of fluid throguh the human capillary wall in relation to venous pressure and to the collogid osmotic pressure of the blood,” J. Clin. Invest., vol. 11, no. 1, pp. 63–95, 1932.
- M. Pottier, A. Dubreuil, and H. Monod, “The effects of sitting posture on the volume of the foot,” Ergonomics, vol. 12, no. 5, pp. 753–758, 1969.
- R. L. Waterfield, “The effect of posture on the volume of the leg,” J Physiol, vol. 72, no. 1, pp. 121–131, 1931.
- J. B. . Youmans, H. S. Wells, D. Donley, D. G. Miller, and H. Frank, “The effect of posture (standing) on the serum protein concentration and colloid osmotic pressure of blood from the foot in relation to the formation of edema,” J. Clin. Invest., vol. 13, no. 3, pp. 447–459, 1934.
- P. Avasthey and E. H. Wood, “Intrathoracic and venous pressure relationships during responses to changes in body position,” J Appl Physiol, vol. 37, no. 2, pp. 166–175, 1974.
- G. Baccelli, P. Pacenti, S. Terrani et al., “Scintigraphic recording of blood volume shifts,” J. Nucl. Med., vol. 36, no. 11, pp. 2022–2031, 1995.
- W. Hildebrandt, H. C. Gunga, J. Herrmann, L. Rocker, K. Kirsch, and J. Stegemann, “Enhanced slow caudad fluid shifts in orthostatic intolerance after 24-h bed-rest,” Eur J Appl Physiol Occup Physiol, vol. 69, no. 1, pp. 61–70, 1994.
- N. Terada and T. Takeuchi, “Postural changes in venous pressure gradients in anesthetized monkeys,” Am. J. Physiol, vol. 264, no. 1, pp. H21–25, 1993.
- D. Yumino, S. Redolfi, P. Ruttanaumpawan et al., “Nocturnal rostral fluid shift: a unifying concept for the pathogenesis of obstructive and central sleep apnea in men with heart failure,” Circulation, vol. 121, no. 14, pp. 1598–1605, 2010.
- B. E. Schroth, “Evaluation and management of peripheral edema,” JAAPA, vol. 18, no. 11, pp. 29–34, 2005.
- A. Yadollahi, F. Rudzicz, S. Mahallati, M. Coimbra, and T. D. Bradley, “Acoustic Estimation of Neck Fluid Volume,” Ann Biomed Eng, vol. 42, no. 10, pp. 2132–2142, 2014.
- J. J. . Fredberg, M. E. Wohl, G. M. Glass, and H. L. Dorkin, “Airway area by acoustic reflections measured at the mouth,” J Appl Physiol Respir Environ Exerc Physiol, vol. 48, no. 5, pp. 749–758, 1980.
- S. Demura, S. Sato, and T. Kitabayashi, “Percentage of total body fat as estimated by three automatic bioelectrical impedance analyzers,” J Physiol Anthropol Appl Human Sci, vol. 23, no. 3, pp. 93–99, 2004.
- F. Zhu, D. Schneditz, E. Wang, and N. W. Levin, “Dynamics of segmental extracellular volumes during changes in body position by bioimpedance analysis,” J. Appl. Physiol., vol. 85, no. 2, pp. 497–504, 1998.
- M. Y. Jaffrin and H. Morel, “Body fluid volumes measurements by impedance: A review of bioimpedance spectroscopy (BIS) and bioimpedance analysis (BIA) methods,” Med Eng Phys, vol. 30, no. 10, pp. 1257–1269, 2008.
- U. G. Kyle, I. Bosaeus, A. D. De Lorenzo et al., “Bioelectrical impedance analysis–part I: review of principles and methods,” Clin Nutr, vol. 23, no. 5, pp. 1226–1243, 2004.
- A. De Lorenzo, A. Andreoli, J. Matthie, and P. Withers, “Predicting body cell mass with bioimpedance by using theoretical methods: a technological review,” J. Appl. Physiol., vol. 82, no. 5, pp. 1542–1558, 1997.
- D. Bracco, D. Thiebaud, R. L. Chiolero, M. Landry, P. Burckhardt, and Y. Schutz, “Segmental body composition assessed by bioelectrical impedance analysis and DEXA in humans,” J. Appl. Physiol., vol. 81, no. 6, pp. 2580–2587, 1996.
- C. H. Ling, A. J. de Craen, P. E. Slagboom et al., “Accuracy of direct segmental multi-frequency bioimpedance analysis in the assessment of total body and segmental body composition in middle-aged adult population,” Clin Nutr, vol. 30, no. 5, pp. 610–615, 2011.
- A. Tagliabue, A. Andreoli, M. Comelli et al., “Prediction of lean body mass from multifrequency segmental impedance: influence of adiposity,” Acta Diabetol, vol. 38, no. 2, pp. 93–97, 2001.
- F. Zhu, M. K. Kuhlmann, P. Kotanko, E. Seibert, E. F. Leonard, and N. W. Levin, “A method for the estimation of hydration state during hemodialysis using a calf bioimpedance technique,” Physiol Meas, vol. 29, no. 6, pp. S503–516, 2008.
- A. Yadollahi, B. Singh, and T. D. Bradley, “Investigating the Dynamics of Supine Fluid Redistribution Within Multiple Body Segments Between Men and Women,” Ann Biomed Eng, vol. 43, no. 9, pp. 2131–2142, 2015.
- M. Fenech and M. Y. Jaffrin, “Extracellular and intracellular volume variations during postural change measured by segmental and wrist-ankle bioimpedance spectroscopy,” IEEE Trans Biomed Eng, vol. 51, no. 1, pp. 166–175, 2004.
- XITRON, HYDRA ECF/ICF (Model 4200), Bio-impedance spectrum analyzer, For measuring intracellular and extracellular fluid volumes. Operating manual, XITRON Technologies Inc., 2007.
- I. Jolliffe, Principal component analysis, Wiley Online Library, 2002.
- J. A. Hartigan and M. A. Wong, “A k-means clustering algorithm: Algorithm AS 136,” Applied statistics, vol. 28, no. 1, pp. 100–108, 1979.
- N. E. Ahlberg, O. Bartley, and N. Chidekel, “Right and left gonadal veins. An anatomical and statistical study,” Acta Radiol Diagn (Stockh), vol. 4, no. 6, pp. 593–601, 1966.
- H. Gray, “The veins of the abdomen and pelvis,” in Anatomy of the Human Body, C. Goss, Ed., pp. 709–715, Lea & Febiger, Philadelphia, PA, 29th edition, 1973.
- D. D. White and L. D. Montgomery, “Pelvic blood pooling of men and women during lower body negative pressure,” Aviat Space Environ Med, vol. 67, no. 6, pp. 555–559, 1996.
- S. Redolfi, I. Arnulf, M. Pottier et al., “Attenuation of obstructive sleep apnea by compression stockings in subjects with venous insufficiency,” Am. J. Respir. Crit. Care Med., vol. 184, no. 9, pp. 1062–1066.
- S. Redolfi, I. Arnulf, M. Pottier, T. D. Bradley, and T. Similowski, “Effects of venous compression of the legs on overnight rostral fluid shift and obstructive sleep apnea,” Respir Physiol Neurobiol, vol. 175, no. 3, pp. 390–393, 2011.
- L. H. White, O. D. Lyons, A. Yadollahi, C. M. Ryan, and T. D. Bradley, “Effect of below-the-knee compression stockings on severity of obstructive sleep apnea,” Sleep Med., vol. 16, no. 2, pp. 258–264, 2015.
- S. Redolfi, M. Bettinzoli, N. Venturoli et al., “Attenuation of obstructive sleep apnea and overnight rostral fluid shift by physical activity,” Am. J. Respir. Crit. Care Med., vol. 191, no. 7, pp. 856–858, 2015.
- T. Kasai, T. D. Bradley, O. Friedman, and A. G. Logan, “Effect of intensified diuretic therapy on overnight rostral fluid shift and obstructive sleep apnoea in patients with uncontrolled hypertension,” J. Hypertens., vol. 32, no. 3, pp. 673–680, 2014.
- I. H. Iftikhar, C. E. Kline, and S. D. Youngstedt, “Effects of exercise training on sleep apnea: a metaanalysis,” Lung, vol. 192, no. 1, pp. 175–184, 2014.
- C. E. Kline, E. P. Crowley, G. B. Ewing et al., “The effect of exercise training on obstructive sleep apnea and sleep quality: a randomized controlled trial,” Sleep, vol. 34, no. 12, pp. 1631–1640, 2011.
- A. A. Goddard, C. S. Pierce, and K. J. McLeod, “Reversal of lower limb edema by calf muscle pump stimulation,” J Cardiopulm Rehabil Prev, vol. 28, no. 3, pp. 174–179, 2008.
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