小方法解决大问题：增加吸气阻力纠正直立性低血压
Increasing Inspiratory Impedance Corrects Orthostatic HypotensionNEW YORK (Reuters Health) Aug 23 - Relatively simple measures that increase inspiratory impedance will often correct orthostatic hypotension related to autonomic failure, investigators report.
Leg muscle tensing, inspiration through pursed lips, inspiratory sniffing, and inspiratory obstruction with a two-way non-rebreather mask cause activation of the respiratory pump and thereby increases mean arterial pressure, "provided hyperventilation is avoided," Dutch investigators report in the August issue of Neurology.
Ten patients with orthostatic hypotension caused by autonomic failure were studied by Dr. Roland D. Thijs and colleagues at Leiden University Medical Center.
Blood pressure was recorded after standing up in five conditions: normal standing; with leg muscle tensing; with inspiratory pursed lip breathing and respiratory sniffing; and with inspiratory impedance caused by narrowing of the inspiratory tube of a two-way non-rebreathing valve.
Mean arterial pressure increased a mean of 8 mm Hg with obstructed inspiration via non-rebreather and 9 mm Hg with leg muscle tensing.
The effect of pursed lip inspiration and inspiratory sniffing on mean arterial pressure depended upon accompanying hyperventilation.
"It should be observed that even small increases of standing mean arterial pressure can dramatically improve orthostatic tolerance in autonomic failure if blood pressure is critically low," the investigators observe.
"It may ... be wise to teach patients a variety of maneuvers and to select the individually most advantageous one," Dr. Thijs and colleagues suggest.
Neurology 2007;69:582-585.
[url]http://www.medscape.com/viewarticle/561826[/url]
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