Document Detail


The effect of breathing manner on inferior vena caval diameter.
MedLine Citation:
PMID:  20980326     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
AIMS: Although the inspiratory 'collapse' of the inferior vena cava (IVC) has been used to signify normal central venous pressure, the effect of the manner of  breathing  IVC size is incompletely understood. As intra-abdominal pressure rises during descent of the diaphragm, we hypothesized that inspiration through diaphragmatic excursion may have a compressive effect on the IVC.
METHODS AND RESULTS: We measured minimal and maximal intrahepatic IVC diameter on echocardiography and popliteal venous return by spectral Doppler during isovolemic inspiratory efforts in 19 healthy non-obese volunteers who were instructed to inhale using either diaphragmatic or chest wall expansion. During inspiration, the maximal diaphragmatic excursion and popliteal vein flow were compared between breathing methods. The IVC 'collapsibility index,' IVCCI, was calculated as (IVC(max)-IVC(min))/IVC(max). The difference in diaphragmatic excursion between diaphragmatic and chest wall breaths in each subject was correlated with the corresponding change in IVCCI. Diaphragmatic breathing resulted in more diaphragmatic excursion than chest wall breathing (median 3.4 cm, range 1.7-5.8 vs. 2.2 cm, range 1.0-5.2, P= 0.0003), and was universally associated with decreased popliteal venous return (19/19 vs. 9/19 subjects, P< 0.004). The difference in diaphragmatic excursion correlated with the difference in IVCCI (Spearman's rho = 0.53, P= 0.024).
CONCLUSION: During inspiration of equivalent tidal volumes, the reduction in IVC diameter and lower extremity venous return was related to diaphragmatic excursion, suggesting that the IVC may be compressed through descent of the diaphragm.
Authors:
Bruce J Kimura; Randy Dalugdugan; Glynn W Gilcrease; James N Phan; Brian K Showalter; Tanya Wolfson
Related Documents :
17352526 - An alternative approach to the monitoring of respiration by dynamic air-pressure sensor.
24359106 - Effects of prostaglandin analogues on aqueous humor outflow pathways.
19643216 - Cardio-respiratory coupling depends on the pons.
3949656 - Immediate response to resistive loading in anesthetized humans.
21228576 - Hydrogen sulfide, a toxic gas with cardiovascular properties in uremia: how harmful is it?
10862216 - How often do office blood pressure measurements fail to identify true hypertension? an ...
Publication Detail:
Type:  Journal Article     Date:  2010-10-27
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  12     ISSN:  1532-2114     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  120-3     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Scripps Mercy Hospital, University of California, 4060 Fourth Ave #206, San Diego, CA 92103, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Sexual dimorphism in resource acquisition and deployment: both size and timing matter.
Next Document:  Usefulness of transthoracic Doppler echocardiography for noninvasive assessment of coronary blood fl...