Critchley L A, Conway F, Anderson P J, Tomlinson B, Critchley J A
Departments of Anaesthesia & Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Clin Auton Res. 1997 Apr;7(2):97-101. doi: 10.1007/BF02267754.
The haemodynamic effects of head-up tilt (HUT) at different tilt angles were investigated non-invasively in eight normal male subjects. Mean arterial pressure (MAP; by Ohmeda Finapres 2300), stroke volume (SV) and heart rate (HR; by BoMed NCCOM3-R7S) were continuously recorded whilst performing a series of HUTs (55 degrees, 10 degrees, 20 degrees, 30 degrees and 55 degrees) lasting 3 min each. The response to HUT was proportional to the sinc of the tilt angle. The magnitude of the response varied between subjects. HUT to 55 degrees resulted in mean (95% confidence limits) increases in MAP by 16 (+/-16)% and HR by 11 (+/-24)% and a decrease in SV by -25 (+/-22)%. These results were repeatable after 30 min. At small tilt angles, i.e. < or = 20 degrees, MAP did not change and HR decreased by -3 (+/-4)%. A detailed analysis revealed immediate dynamic (0-30 s), late dynamic (30-90 s) and plateau (after 90 s) phases in the response to HUT. In conclusion, HUT produces reproducible haemodynamic effects, although differences exist among subjects. A detailed analysis of these effects can be successfully performed using non-invasive methods.
在8名正常男性受试者中,对不同倾斜角度的头高位倾斜(HUT)的血流动力学效应进行了无创研究。在进行一系列每次持续3分钟的HUT(55度、10度、20度、30度和55度)时,连续记录平均动脉压(MAP;使用Ohmeda Finapres 2300)、心输出量(SV)和心率(HR;使用BoMed NCCOM3-R7S)。对HUT的反应与倾斜角度的正弦成正比。不同受试者之间反应的幅度有所不同。倾斜至55度导致MAP平均(95%置信区间)升高16(±16)%,HR升高11(±24)%,SV降低-25(±22)%。30分钟后这些结果可重复。在小倾斜角度,即≤20度时,MAP不变,HR降低-3(±4)%。详细分析显示,对HUT的反应存在即时动态(0 - 30秒)、延迟动态(30 - 90秒)和平稳期(90秒后)阶段。总之,HUT产生可重复的血流动力学效应,尽管受试者之间存在差异。使用无创方法可以成功地对这些效应进行详细分析。