Research Service, VA Boston Healthcare System, Department of Medicine, Harvard Medical School, Boston, MA 55115, USA.
Spinal Cord. 2010 May;48(5):434-5. doi: 10.1038/sc.2009.148. Epub 2009 Nov 24.
Case report.
To describe a role for breathing in maintenance for blood pressure in a tetraplegic man.
Veterans Administration Hospital, USA.
METHODS/RESULTS: A 60-year-old man, tetraplegic for 14 years, was successfully treated for orthostatic hypotension (OH) by raising the head of his bed in the mornings before transfer to his wheelchair. To test the role of breathing in the compensation for OH, we monitored the nasal airflow with a thermistor clipped onto a naris and pulse pressure was measured with a transducer held against a supraorbital artery with an elastic band. On raising the head of the bed to 30 degrees the pulse pressure fell and breathing effort increased. Within 1 min, however, pulse pressure rose to baseline levels whereas increased breathing effort continued. On transfer to his wheelchair OH was avoided and medication was unnecessary.
For the tetraplegic subject the partial raising of the head of the bed for a period of time to be determined individually will recruit increased breathing effort and venous return to the chest, preventing OH on transfer to an upright position in a wheelchair.
病例报告。
描述呼吸在维持四肢瘫痪男性血压中的作用。
美国退伍军人管理局医院。
方法/结果：一名 60 岁男子，四肢瘫痪 14 年，通过在早上将床头抬高到轮椅转移之前来成功治疗直立性低血压（OH）。为了测试呼吸在 OH 代偿中的作用，我们用热敏电阻夹在一个鼻孔上来监测鼻气流，并用弹性带将换能器贴在上眼眶动脉上来测量脉压。将床头抬高到 30 度时，脉压下降，呼吸努力增加。然而，在 1 分钟内，脉压上升到基线水平，而增加的呼吸努力持续。在转移到轮椅上时，避免了 OH，且无需药物治疗。
对于四肢瘫痪患者，通过个人确定的一段时间来部分抬高床头，将募集增加的呼吸努力和静脉回流到胸部，从而防止在轮椅上直立转移时发生 OH。
