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: 3419870
• 负责人: BARBARA A THERRIEN
• 金额: --
• 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 1986-09-27
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3419870
• 关键词: aging; blood pressure; cardiovascular disorder; cerebrovascular disorders; electrocardiographic monitor; hemodynamics; human middle age (35-64); nurses; nursing research; nursing skill /technique; posture; ultrasound blood flow measurement; young adult human (21-34)

The purpose of this study is to explore the effects of commonly used bed and chair positions on the intensity of hemodynamic responses to the Valsalva Maneuver in normal subjects. The Valsalva Maneuver, forced expiration against a closed glottis, is a normal physiological function performed many times daily. Within seconds the force of this strain results in marked shifts of cardio- and cerebrovascular 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 cerebro-vascular disease. Although nurses can attempt to decrease the incidences 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. We hypothesize that body position may alter the physiological responses of the Valsalva Maneuver. In Phase I of the study a minimum of 75 healthy male and 75 healthy female adults between the ages of 30-55 years of age will be tested in four commonly used bed positions (supine, lateral recumbent, thirty and seventy-degree angle upright) and a chair position. In Phase II, 30 healthy males and 30 healthy females over the age of 55 will be tested in two body positions -- those found to create the least and greatest amount of hemodynamic change in the 30-55-year-old subjects. All subjects will be asked to strain by blowing into a pressure-gauge meter to a pressure of 40 mmHg, to hold this pressure for ten seconds and to then release the strain. A strain gauge applied to the level of the diaphram will confirm the duration of the strain. Heart rate and rhythm will be recorded on a cardiac monitor and carotid artery flow velocity recorded using a transcutaneous Doppler flowmeter, 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 into 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 repeated in all positions. Data will be analyzed by two factor analysis of variance with repeated measures, spectral density and cross-correlational techniques.

这项研究的目的是探索常用的床的效果 和椅子位置对血流动力学反应强度的影响 正常受试者的Valsalva动作。瓦尔萨尔瓦动作，强制动作 呼气时声门紧闭，是正常的生理功能 每天表演很多次。在几秒钟内，这种紧张的力量 导致心脑血管血流量显著变化和 压力。临床上有反复或劳累的情况 瓦尔萨尔瓦的表演是危险的，特别是对于患有 现有的心脏或脑血管疾病。尽管护士可以尝试 要减少劳累的发生率，并不是所有的都可以消除。 旨在减轻这种压力对血流动力学影响的努力 对瓦尔萨尔瓦行动的回应势在必行。我们假设 身体位置可能会改变瓦尔萨尔瓦人的生理反应 机动点。在研究的第一阶段，至少75名健康男性和75名健康男性 年龄在30-55岁之间的健康女性成年人将接受测试 在四种常用的卧位(仰卧、侧卧、三十卧位和 70度直立角度)和椅子位置。在第二阶段，30 健康的男性和30名55岁以上的健康女性将在 两个身体姿势--可以创造最少和最多的体位 观察30~55岁受试者的血流动力学变化。所有的科目都将是 被要求向压力表吹气，使压力达到40摄氏度 毫米汞柱，保持这一压力十秒钟，然后释放 紧张。将应变计应用于隔膜的水平将确认 菌株的持续时间。心率和节律将被记录在 心脏监护仪和颈动脉血流速度记录使用 经皮多普勒血流计，在治疗前、治疗中和治疗后 Valsalva菌株，直到重新确定基线措施。基线 将测定收缩压和舒张压，收缩压 压力将通过多普勒技术在5秒内进入 应变，在菌株释放后5秒，每分钟 此后，直到再次达到基线压力。此程序将 在所有位置重复。数据将通过两因素分析进行分析 重复测量的方差、谱密度和 交叉相关技术。