Journal of Korean Biological Nursing Science

  • 제11권1호
  • /
  • Pages.68-76
  • /
  • 2009
  • /
  • 2383-6415(pISSN)
  • /
  • 2383-6423(eISSN)
한국기초간호학회 (Korean society of Biological Nursing Science)
권호 표지

Valsalva Maneuver에 따른 정상 성인의 지속적 혈류역동 변화

Continuous Hemodynamic Profiles of Healthy Adults during Valsalva Maneuver

  • 투고 : 2009.04.28
  • 심사 : 2009.05.30
  • 발행 : 2009.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The purpose of this study was to evaluate the hemodynamic changes in degree and duration that occur during Valsalva maneuver (VM). Furthermore, we wanted to investigate the patterns and mechanisms of physiological hemodynamic control. Method: Thirty six healthy college students were recruited from Y university. Each participant was provided with written informed consent. Blood pressure (BP), heart rate (HR), cardiac output (CO) were continuously recorded using the Finometer. Result: During the phase I of VM, means of systolic and diastolic pressures were increased by 32.15% and 38.28%, respectively, compared with basal values. HR and CO were decreased by 9.91% and 13.01%, respectively. Immediately after the maneuver (phase III), systolic and diastolic pressures were decreased by 5.05% and 6.24%, respectively, compared with those obtained in the phase II. HR and CO were elevated by 13.33% and 11.93%, respectively, compared to the levels of earlier phases. BPs were represented with overshoot in the phase IV, and recovered by baseline values about 20 sec after VM. Conclusion: These results demonstrated that hemodynamic changes are variable in the event of VM even in healthy humans. It will be valuable to accumulate more quantitative hemodynamic information in special populations such as the elderly and the patients with cardiovascular problems.

키워드

참고문헌

  1. Badeer, H. S. (1984). Cardiovascular physiology. New York: Karger.
  2. Bannister, R. (1980). Arterial blood pressure and hypertension. Sleight P, editer. Oxfored UK: Oxford Univ Press.
  3. Choi, K. S. (2006). A study on variation body composition, blood pressure, VO2max, after a contest in the bodybuilders. Korea Sport Res, 17, 217-226.
  4. Choi, M. A., Kim, J. H., Park, M. J., Choi, S. M., & Lee, K. S. (2004). Physiology (ed 4). Seoul: Hounmoonsa Publishing.
  5. Choi, M. A., & Kim, J. I. (1986). A study on effect of repeated valsalva maneuver on the circulation of healthy adults. J Nur Acad Soc, 16, 49-54. https://doi.org/10.4040/jnas.1986.16.1.49
  6. Choi, M. A., Kim, J. I., Kim, H. L. (1989). Effect of changing position from supine to standing upright on the circulation in healthy adults. J Nur Acad Soc, 19, 285-298. https://doi.org/10.4040/jnas.1989.19.3.285
  7. Guyton, A. C., & Hall, J. E. (2000). Medical physiology (11th eds.). Philadelphia: W. B. Saunders company.
  8. Joung, I. G., Oh, M. J., Youn, J. S., Kim, J. O., Lee, I. W., Kim, M. G., & Gang, G. S. (2005). The effects of exercise types and valsalva maneuver on cerebral arterial blood flow. J sport leisure studies, 23, 403-410.
  9. Lee, J. H., Cha, T. J., Kim, J. L., Gang, W. C., Yang, S. L., Lee, C. R., & You, C., I. (2002). Cohort study on effect of long-term noise exposure on the blood pressure. The Korean J Prev Med, 35, 205-213.
  10. Lee, S. M. (2004). Cardiac output measurement. J Korean Soc Anesthesiol, 46, 1-9. https://doi.org/10.4097/kjae.2004.46.1.1
  11. Liang, F., & Liu, H. (2006). Simulation of hemodynamic responses to the Valsalva Maneuver: An integrative computational model of the cardiovascular system and the autonomic nervous system. J Physiol Sci, 56, 45-65. https://doi.org/10.2170/physiolsci.RP001305
  12. Low, P. A. (1993). Autonomic nervous system function. J Clin Neurophysiol, 10, 14-27. https://doi.org/10.1097/00004691-199301000-00003
  13. Porth, C. J., Bamrah, V. S., Tristani, F. E., & Smith, J. J. (1984). The Valsalva Maneuver: mechanisms and clinical implications. Heart Lung, 13, 507-518.
  14. Prabhakar, H., Bithal, P. K., Suri, A., Rath, G. P., & Dash, H. H. (2007). Intracranial pressure changes during Valsalva manoeuvre in patients undergoing a neuroendoscopic procedure. Minim Invasive Neurosurg, 50, 98-101. https://doi.org/10.1055/s-2007-982505
  15. Schievink, W. I., Karemaker, J. M., Hageman, L. M., & van der Werf, D. J. (1989). Circumstances surrounding aneurysmal hemorrhage. Surg Neurol, 32, 266-272. https://doi.org/10.1016/0090-3019(89)90228-0
  16. Seo, S. H. (1999). Computational fluid dynamic approach to the field of hemodynamics. 1999 KSCFE fall Conference, 1-6.
  17. Shin, M. G., & Jo, W. S. (1997). Human physiology. Seoul: Hounmoonsa Publishing.
  18. Smith, J. J., & Kampine, J. P. (1980). Circulatory physiology: The essentials, Baltimore: Williams and Wilkins.
  19. Sun, Y., Mazen, B., Rechard, J. L., & Salvatore, A. C. (1997). A comprehensive model for tight-left heart interaction under the influence of pericardium and baroreflex. Am J Physiol, 272, H1499-1515. https://doi.org/10.1152/ajpcell.1997.272.5.C1499
  20. Therrien, B. (1990). Position modifies carotid artery blood flow velocity during straining. Res Nurs Health, 13, 69-76. https://doi.org/10.1002/nur.4770130203
  21. Tiecks, F. P., Lam, A. M., Matta, B. F., Strebel, S., Douville, C., & Newell, D. W. (1995). Effects of the Valsalva Maneuver on cerebral circulation in healthy adults. Stroke, 26, 1386-1392. https://doi.org/10.1161/01.STR.26.8.1386
  22. Wendling, W., Sadel, S., Jimenez, D., Rosenwasser, R., & Buchheit, W. (1994). Cardiovascular and cerebrovascular effects of the applied Valsalva manoeuvre in anaesthetized neurosurgical patients. Eur J Anaesthesiol, 11, 81-87.
  23. Wostyn, P., Audenaert, K., & De Deyn, P. P. (2009). The Valsalva maneuver and Alzheimer's disease: is there a link? Curr Alzheimer Res, 6, 59-68. https://doi.org/10.2174/156720509787313943
  24. Zhang, R., Crandall, C. G., & Levine, B. D. (2009). Cerebral hemodynamics during the Valsalva Maneuver-insights from ganglionic blockade. Stroke, 35, 843-847. https://doi.org/10.1161/01.STR.0000120309.84666.AE