TY - JOUR
T1 - Use of lower abdominal compression to combat orthostatic hypotension in patients with autonomic dysfunction
AU - Smit, Adrianus A.J.
AU - Wieling, Wouter
AU - Fujimura, Jiro
AU - Denq, Jong C.
AU - Opfer-Gehrking, Tonette L.
AU - Akarriou, Mohammed
AU - Karemaker, John M.
AU - Low, Phillip A.
N1 - Funding Information:
■ Acknowledgements This study was supported by grants from the Nederlandse Organisatie voor Wetenschappelijk Onderzoek (SIR 15–1535 and SIR 15–1667), the Prinses Beatrix Fonds (96FS01), and the United States of America National Aeronautics and Space Administration (NAGW 4385 and PO1 NS3 2352).
PY - 2004/6
Y1 - 2004/6
N2 - The aim of this study was to investigate in patients with neurogenic orthostatic hypotension the mechanism and usefulness of abdominal compression to increase standing blood pressure. In three protocols, 23 patients underwent abdominal compression. Protocol 1 evaluated in a 40-60° head-up-tilt position, the effect of abdominal compression on caval vein and femoral diameter, arterial blood pressure and hemodynamics. Protocol 2 documented the relationship between the level of compression and the arterial pressure response. Protocol 3 investigated the ability to maintain standing blood pressure by an elastic binder. During head-up-tilt, compression (40 mm Hg) resulted in a reduction in diameter of the caval vein (mean -2.6 mm, range -1.4 to 0.6), without a change in femoral vein diameter. Stroke volume increased by 14% (range -1 to 23) and blood pressure (systolic/diastolic) by 30/14 mm Hg (range 7/2 to 69/36), both p < 0.05; 40 mm Hg compression was associated with a higher pressure response than 20 mm Hg (mean 18/8 mm Hg, range 6/2 to 43/20 vs. mean 9/4 mm Hg, range -1/0 to 18/8, p < 0.05). Elastic abdominal binding increased standing blood pressure with 15/6 mm Hg (range -3/3 to 36/14, p < 0.05). We conclude that in patients with neurogenic orthostatic hypotension, abdominal compression increases standing blood pressure to a varying degree by increasing stroke volume.
AB - The aim of this study was to investigate in patients with neurogenic orthostatic hypotension the mechanism and usefulness of abdominal compression to increase standing blood pressure. In three protocols, 23 patients underwent abdominal compression. Protocol 1 evaluated in a 40-60° head-up-tilt position, the effect of abdominal compression on caval vein and femoral diameter, arterial blood pressure and hemodynamics. Protocol 2 documented the relationship between the level of compression and the arterial pressure response. Protocol 3 investigated the ability to maintain standing blood pressure by an elastic binder. During head-up-tilt, compression (40 mm Hg) resulted in a reduction in diameter of the caval vein (mean -2.6 mm, range -1.4 to 0.6), without a change in femoral vein diameter. Stroke volume increased by 14% (range -1 to 23) and blood pressure (systolic/diastolic) by 30/14 mm Hg (range 7/2 to 69/36), both p < 0.05; 40 mm Hg compression was associated with a higher pressure response than 20 mm Hg (mean 18/8 mm Hg, range 6/2 to 43/20 vs. mean 9/4 mm Hg, range -1/0 to 18/8, p < 0.05). Elastic abdominal binding increased standing blood pressure with 15/6 mm Hg (range -3/3 to 36/14, p < 0.05). We conclude that in patients with neurogenic orthostatic hypotension, abdominal compression increases standing blood pressure to a varying degree by increasing stroke volume.
KW - Abdominal compression
KW - Autonomic dysfunction
KW - Autonomic nervous system
KW - Blood pressure
KW - Braces
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U2 - 10.1007/s10286-004-0187-x
DO - 10.1007/s10286-004-0187-x
M3 - Article
C2 - 15241645
AN - SCOPUS:3242676724
SN - 0959-9851
VL - 14
SP - 167
EP - 175
JO - Clinical Autonomic Research
JF - Clinical Autonomic Research
IS - 3
ER -