| Abstrakt: |
In a study on non-invasive assessment of pulmonary capillary wedge pressure (PCWP), we sought a method to increase PCWP non-invasively. We hypothesized that inflation of an anti-G garment was suitable to increase PCWP non-invasively in healthy elderly subjects. In 20 subjects, aged 70 ± 4 years (mean ± SD), before, immediately after, and 4 min after anti-G garment inflation to 52 mmHg, PCWP and mean pulmonary artery pressure (MPAP) were measured with a Swan-Ganz catheter, and mean arterial blood pressure (MAP) with Finapres, in supine and semi-recumbent position. Supine, PCWP (mmHg, mean ± SD) increased from 9·9 ± 2·1 to 15·5 ± 3·9** immediately after inflation and 13·4 ± 3·7** at 4 min; semi-recumbent from 8·9 ± 2·0 to 17·5 ± 3·3** and 14·7 ± 2·9** (* P<0·05,** P<0·001 versus before inflation). MPAP (mmHg) increased after inflation: supine 16·9 ± 2·3 to 22·3 ± 4·6** and 20·6 ± 3·9** and semi-recumbent 15·7 ± 2·8 to 24·3 ± 5·1** and 22·5 ± 3·5**, suggesting that increased preload was the primary effect of anti-G garment inflation. Supine MAP (mmHg) increased from 96·0 ± 11·3 to 101·4 ± 13·4** and 100·5 ± 12·7* and semi-recumbent from 102·0 ± 8·9 to 108·3 ± 11·4** and 106·0 ± 11·3*, suggesting an effect of increased afterload as well. The latter was supported by an increase in total peripheral resistance (d s cm−5) from 1346 ± 299 to 1441 ± 384 after 4 min (P = 0·057) and from 1461 ± 341 to 1532 ± 406 (P = 0·054), supine and semi-recumbent respectively, while cardiac output remained unchanged. Complications did not occur. We conclude that in healthy elderly subjects, anti-G garment inflation is a safe, non-invasive, method to induce a significant increase in PCWP. Our findings justify its application in future studies in which non-invasive temporary increase in PCWP is required. [ABSTRACT FROM AUTHOR] |
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