NURSING ACTION: BODY POSITION AND VALSALVA INTENSITY

护理动作：身体姿势和瓦萨尔瓦动作强度

• 批准号: 3391145
• 负责人: BARBARA A THERRIEN
• 金额: $ 18.64万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 1984
• 资助国家: 美国
• 起止时间: 1984-09-28 至 1989-12-27
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3391145
• 关键词: blood pressure; blood volume; cardiovascular disorder; cerebrovascular disorders; diabetes mellitus; electrocardiographic monitor; gender difference; heart rate; heart rhythm; hemodynamics; human middle age (35-64); human subject; hypertension; nursing research; nursing skill /technique; obesity; posture; ultrasound blood flow measurement; young adult human (21-34)

Our purpose is to explore the effects of commonly used body positions in bed on the intensity of hemodynamic responses to the Valsalva Maneuver in subjects who have mild chronic disorders of the vascular system in which the normal pattern of responses may be altered. The Valsalva Maneuver, forced expiration against a closed glottis, is a normal physiological function performed by everyone many times daily. Within seconds the force of this strain results in marked shifts of cardio- and cerebro-vascular blood flow and pressure. There are clinical situations in which repeated or strenuous performance of the Valsalva is hazardous, particularly for individuals with existing cardiac or cerebo-vascular disease. Although nurses can attempt to decrease the incidence of straining, not all can be eliminated. Efforts aimed at lessening the intensity of this strain on the hemodynamic responses to the Valsalva Maneuver are imperative. Data from year one of this project has shown that body position and gender affect the hemodynamic responses to the Valsalva Maneuver in healthy adults between the ages of 30-55. The major goal is to determine whether the hemodynamic responses to the Valsalva Maneuver change in the same way, as a function of body position, for individuals with: increased body mass and blood volume (overweight), diminished peripheral vasomotor tone (diabetics) and increased peripheral resistance (mild hypertensives) as they do in normal subjects. During years 1 and 2, 50 overweight males, 50 overweight females and 30 diabetic males, 30 diabetic females between the ages of 30-55 will be tested twice in each of five positions (supine, lateral recumbant, 30 and 70 degree upright and chair). In year 3, 50 males and 50 females with mild hypertension will be tested in 3 positions (lateral recumbent, 30 and 70 degree upright). All subjects will be asked to strain by blowing into a pressure-guage meter to a pressure of 40 mmHg, to hold this pressure for ten seconds and to then release the strain. Heart rate and rhythm will be recorded on a cardiac monitor, carotid artery flow velocity recorded using a transcutaneous Doppler flowmeter, and peripheral blood volume recorded using a plethysmograph, prior to, during and following the Valsalva strain and until baseline measures are re-established. Baseline systolic and diastolic blood pressure will be determined; systolic blood pressure will be taken by Doppler technique at five seconds ino the strain, at five seconds after the release of the strain and each minute thereafter until baseline pressure is again reached. This procedure will be completed twice in each position. Data will be analyzed by two factor analysis of variance with repeated measures, time series analysis, and analyses of covariance.

我们的目的是探讨常用的身体姿势的影响， 床对Valsalva动作的血流动力学反应强度， 患有轻度慢性血管系统疾病的受试者，其中 正常的反应模式可能会改变。 瓦尔萨尔瓦演习， 对着关闭的声门用力呼气，是正常的生理反应。 每个人每天都要做很多次。 几秒钟之内， 这种应变的结果在显着的变化，心血管和血管 血流量和压力。 在临床上， 或剧烈的Valsalva性能是危险的，特别是对于 患有心脏或脑血管疾病的人。 虽然 护士可以尝试减少紧张的发生率，但不是所有人都可以。 淘汰 旨在减轻对巴勒斯坦人民的这种压力的努力， 对瓦尔萨尔瓦动作的血流动力学反应是必要的。 数据从 该项目的第一年表明，身体位置和性别影响 健康成人Valsalva动作的血流动力学反应 30-55岁之间。 主要目的是确定血流动力学是否 对瓦尔萨尔瓦机动的反应以同样的方式变化，作为一个函数， 体位，适用于体重和血容量增加的个体 （超重），外周血管张力降低（糖尿病）和 外周阻力增加（轻度高血压患者），与正常 科目 在第1年和第2年，50名超重男性，50名超重女性 年龄在30-55岁之间的30名糖尿病男性和30名糖尿病女性将 在五个位置（仰卧、侧卧、30 和70度直立和椅子）。 在第三年，50名男性和50名女性， 轻度高血压将在3个位置（侧卧位，30和 70度直立）。 所有受试者将被要求通过吹到一个 将压力计的压力调节至40 mmHg，以保持该压力 十秒后释放张力 心率和心律 记录在心脏监护仪上，颈动脉流速记录使用 经皮多普勒血流计，并记录外周血容量 使用体积描记器，在Valsalva应变之前、期间和之后 直到重新建立基线测量。 基线收缩压和 将测定舒张压;收缩压将 用多普勒技术在五秒钟内测量应变， 释放菌株后10秒，此后每分钟，直至 再次达到基线压力。 此程序将完成两次 在每个位置。 数据将采用双因素方差分析进行分析 重复测量、时间序列分析和协方差分析。