Document Detail


Relationship between venous pressure and tissue volume during venous congestion plethysmography in man.
MedLine Citation:
PMID:  9306287     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
1. Venous congestion strain-gauge plethysmography enables the non-invasive assessment of arterial blood flow, fluid filtration capacity (Kf), venous pressure (Pv) and isovolumetric venous pressure (Pvi) in man. One of the major assumptions of this technique, that cuff pressure (Pcuff) applied to the limb equals Pv at the level of the strain gauge, was tested in this study. 2. In nine healthy male volunteers (mean age, 29.3 +/- 1.2 years) the saphenous vein was cannulated with an 18-gauge catheter proximal to the medial malleolus. The subjects were supine and Pv was continuously measured during the application of small step (8-10 mmHg) increases in congestion Pcuff (up to 70 mmHg). Pcuff, changes in limb circumference and Pv were recorded by computer for off-line analysis. Since the determination of Kf is influenced by the changes in plasma oncotic pressure, venous blood samples were obtained at the start of the study, when Pcuff was raised to 30 mmHg and again to 65 mmHg and 4 min after deflation of the cuff. 3. The relationship between Pv and Pcuff was linear over the range of 10-70 mmHg (n = 9, 69 measurements, slope 0.91, r = 0.97, P << 0.001). The non-invasively measured calf Pv, based on the intercept of the relationship between the vascular compliance component (Va) and Pcuff, was 8.0 +/- 0.4 mmHg, which was not significantly different from the corrected invasively measured Pv value of 8.8 +/- 0.3 mmHg (P = 0.08). 4. Venous blood lactate and haemoglobin concentrations, as well as colloid osmotic pressure, total protein and albumin concentrations were unchanged throughout the protocol, whereas significant decreases in PO2 and blood glucose concentration were observed when Pcuff reached 65 mmHg. Assuming a constant oxygen consumption, this may suggest a reduction in tissue perfusion. 5. This study demonstrates the close correlation between Pcuff and Pv in the saphenous vein. Since the small congestion Pcuff step protocol does not cause significant increase in plasma oncotic pressure, we conclude that Pv, as well as Kf, can be accurately determined with this venous congestion plethysmography protocol.
Authors:
F Christ; J Gamble; H Baschnegger; I B Gartside
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Journal of physiology     Volume:  503 ( Pt 2)     ISSN:  0022-3751     ISO Abbreviation:  J. Physiol. (Lond.)     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-11-19     Completed Date:  1997-11-19     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0266262     Medline TA:  J Physiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  463-7     Citation Subset:  IM    
Affiliation:
Institute of Anaesthesiology, Ludwig-Maximilians University Munich, Germany. Frank.Christ@ana.med.uni-muenchen.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Glucose / metabolism
Central Venous Pressure / physiology*
Hemoglobins / metabolism
Humans
Lactic Acid / blood
Male
Plethysmography
Regression Analysis
Saphenous Vein / physiology
Serum Albumin / metabolism
Veins / anatomy & histology*,  physiology*
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobins; 0/Serum Albumin; 50-21-5/Lactic Acid
Comments/Corrections

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