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NURSING ACTION: BODY POSITION AND VALSALVA INTENSITY

护理动作：身体姿势和瓦萨尔瓦动作强度

基本信息

批准号：
3391146
负责人：
BARBARA A THERRIEN
金额：
$ 19.99万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
1984
资助国家：
美国
起止时间：
1984-09-28 至 1990-12-27
项目状态：
已结题

项目摘要

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.

我们的目的是探索常用的身体姿势在卧床时对Valsalva动作的血流动力学反应强度有轻度慢性血管系统疾病的受试者正常的反应模式可能会改变。瓦尔萨尔瓦动作，用力呼气时声门关闭，是一种正常的生理现象由每个人每天多次执行的功能。在几秒钟内，原力导致心脑血管明显移位血流量和血压。在某些临床情况下，反复出现或费力表演瓦尔萨尔瓦是危险的，特别是对患有现有心脏或脑血管疾病的个人。虽然护士可以尝试减少紧张的发生率，但不是所有的都可以被淘汰了。旨在减轻这一压力的强度的努力对瓦尔萨尔瓦手法的血流动力学反应势在必行。数据来自该项目的第一年表明，身体位置和性别会影响健康成人对Valsalva手法的血流动力学反应年龄在30-55岁之间。主要目标是确定血液动力学是否对瓦尔萨尔瓦动作的反应也以同样的方式变化，作为体位，适用于以下情况的个人：体重和血量增加 (超重)，外周血管舒张性紧张(糖尿病患者)和外周阻力增加(轻度高血压患者)，与正常情况一样研究对象。在第一年和第二年，50名超重的男性，50名超重的女性年龄在30-55岁之间的30名糖尿病男性和30名糖尿病女性将在五种体位中每种体位测试两次(仰卧、侧卧，30次和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个体位(侧卧、30和直立70度)。所有受试者将被要求通过吹气进入一个将压力表的压力调至40毫米汞柱，以保持该压力十秒钟，然后释放菌株。心率和节律将是在心脏监护仪上记录，颈动脉血流速度经皮多普勒血流计，记录外周血容量在Valsalva应变之前、期间和之后使用体积描记器直到重新建立基线措施。基线收缩压和将测定舒张压；将测定收缩压通过多普勒技术在5秒内被采集，在5点菌株释放后数秒，此后每分钟，直至再次达到基线压力。此过程将完成两次在每个位置。数据分析采用双因素方差分析采用重复测量、时间序列分析和协方差分析。