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Relationship Between Venous Pressure and tissue Volume During Venous Congestion Plethysmography in Man
Author(s) -
Christ F.,
Gamble J.,
Baschnegger H.,
Gartside I. B.
Publication year - 1997
Publication title -
the journal of physiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.802
H-Index - 240
eISSN - 1469-7793
pISSN - 0022-3751
DOI - 10.1111/j.1469-7793.1997.463bh.x
Subject(s) - medicine , plethysmograph , cuff , supine position , venous pressure , cardiology , anesthesia , sphygmomanometer , vein , blood pressure , surgery
1 Venous congestion strain‐gauge plethysmography enables the non‐invasive assessment of arterial blood flow, fluid filtration capacity ( K f ), venous pressure ( P v )and isovolumetric venous pressure ( P vi )in man. One of the major assumptions of this technique, that cuff pressure ( P euff ) applied to the limb equals P v at the level of the strain gauge, was tested in this study. 2 In nine healthy male volunteers (mean age, 29.3 ± 1.2 years) the saphenous vein was cannulated with an 18‐gauge catheter proximal to the medial malleolus. The subjects were supine and P v was continuously measured during the application of small step (8–10 mmHg) increases in congestion P cuff (up to 70 mm Hg). P cuff , changes in limb circumference and P v were recorded by computer for off‐line analysis. Since the determination of P v is influenced by the changes in plasma oncotic pressure, venous blood samples were obtained at the start of the study, when P & was raised to 30 mmHg and again to 65 mmHg and 4 min after deflation of the cuff. 3 The relationship between P v and P cuff was linear over the range of 10–70 mm Hg ( n = 9 , 69 measurements, slope 0.9.1, r = 0.97 , P. <<0.001). The non‐invasively measured calf P v based on the intercept of the relationship between the vascular compliance component ( V v ) and P cuff , was 8.0±0.4mmHg, which was not significantly different from the corrected invasively measured P v value of 8.8±0.3 mmHg P = 0.08 ). 4 Venous blood lactate and haemoglobin concentrations, as well as colloid osmotic pressure, total protein and albumin concentrations were unchanged throughout the protocol, whereas significant decreases in P o2 and blood glucose concentration were observed when P cuff reached 65 mmHg. Assuming a constant oxygen consumption, this may suggest a reduction in tissue perfusion. 5 This study demonstrates the close correlation between P cuff and P v in the saphenous vein. Since the small congestion P cuff step protocol does not cause significant increase in plasma oncotic pressure, we conclude that P v as well as K f can be accurately determined with this venous congestion plethysmography protocol.