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Spleen volume and blood flow response to repeated breath-hold apneas

Darija Bakovi,¹ Zoran Valic,¹ Davor Eterovi,¹ Ivica Vukovi,² Ante Obad,² Ivana Marinovi-Terzi,¹ and eljko Duji¹

¹Department of Physiology and Biophysics, University of Split School of Medicine, and ²Department of Medicine, Clinical Hospital Split, 21 000 Split, Croatia

Submitted 3 March 2003 ; accepted in final form 16 June 2003

The purpose of this study was 1) to answer whether the reduction in spleen size in breath-hold apnea is an active contraction or a passive collapse secondary to reduced splenic arterial blood flow and 2) to monitor the spleen response to repeated breath-hold apneas. Ten trained apnea divers and 10 intact and 7 splenectomized untrained persons repeated five maximal apneas (A1-A5) with face immersion in cold water, with 2 min interposed between successive attempts. Ultrasonic monitoring of the spleen and noninvasive cardiopulmonary measurements were performed before, between apneas, and at times 0, 10, 20, 40, and 60 min after the last apnea. Blood flows in splenic artery and splenic vein were not significantly affected by breath-hold apnea. The duration of apneas peaked after A3 (143, 127, and 74 s in apnea divers, intact, and splenectomized persons, respectively). A rapid decrease in spleen volume (20% in both apnea divers and intact persons) was mainly completed throughout the first apnea. The spleen did not recover in size between apneas and only partly recovered 60 min after A5. The well-known physiological responses to apnea diving, i.e., bradycardia and increased blood pressure, were observed in A1 and remained unchanged throughout the following apneas. These results show rapid, probably active contraction of the spleen in response to breath-hold apnea in humans. Rapid spleen contraction and its slow recovery may contribute to prolongation of successive, briefly repeated apnea attempts.

spleen contraction; professional divers; ultrasonography; human; diving reflex

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