Patterns of cardiac output response to acute reduction of ventricular preload and afterload pressures

Potanin, Constantine; Sinclair-Smith, Bruce C.

doi:10.1016/0002-9149(70)90616-8

The American Journal of Cardiology

1970

DOI: 10.1016/0002-9149(70)90616-8

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Patterns of cardiac output response to acute reduction of ventricular preload and afterload pressures

Constantine Potanin

Bruce C. Sinclair-Smith

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Cited by 2 publications

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“…One year later, the same investigator16 assessed the effect of reducing venous return, and thus preload and afterload, in patients with either valvular disease or cardiomyopathy. Potanin reported that LBNP caused an immediate and sustained decrease in right atrial and pulmonary capillary wedge pressure in all A C C E P T E D M A N U S C R I P T patients, with the largest decrease occurring in patients with the highest initial pressure.…”

mentioning

confidence: 99%

Lower Body Negative Pressure: Historical Perspective, Research Findings, and Clinical Applications

Crystal

Salem

2015

Journal of Anesthesia History

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mentioning

confidence: 99%

Lower Body Negative Pressure: Historical Perspective, Research Findings, and Clinical Applications

Crystal

Salem

2015

Journal of Anesthesia History

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A comparison of protocols for simulating hemorrhage in humans: step versus ramp lower body negative pressure

Rosenberg

Kay

Anderson

et al. 2021

Journal of Applied Physiology

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Lower body negative pressure (LBNP) elicits central hypovolemia, and has been used to simulate the cardiovascular and cerebrovascular responses to hemorrhage in humans. LBNP protocols commonly employ progressive stepwise reductions in chamber pressure for specific time periods. However, continuous ramp LBNP protocols have also been utilized to simulate the continuous nature of most bleeding injuries. The aim of this study was to compare tolerance and hemodynamic responses between these two LBNP profiles. Healthy human subjects (N=19; age, 27±4 y; 7F/12M) completed a 1) step LBNP protocol (5-min steps), and; 2) continuous ramp LBNP protocol (3 mmHg/min), both to presyncope. Heart rate (HR), mean arterial pressure (MAP), stroke volume (SV), middle and posterior cerebral artery velocity (MCAv and PCAv), cerebral oxygen saturation (ScO2), and end-tidal CO2 (etCO2) were measured. LBNP tolerance, via the cumulative stress index (CSI, summation of chamber pressure*time at each pressure), and hemodynamic responses were compared between the two protocols. The CSI (Step: 911±97 mmHg*min vs. Ramp: 823±83 mmHg*min; P=0.12) and the magnitude of central hypovolemia (%Δ SV, Step: -54.6±2.6 % vs. Ramp: -52.1±2.8 %; P=0.32) were similar between protocols. While there were no differences between protocols for the maximal %Δ HR (P=0.88), the %Δ MAP during the step protocol was attenuated (P=0.05), and the reductions in MCAv, PCAv, ScO2, and etCO2 were greater (P≤0.08) when compared with the ramp protocol at presyncope. These results indicate that when comparing cardiovascular responses to LBNP across different laboratories, the specific pressure profile must be considered as a potential confounding factor.

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Patterns of cardiac output response to acute reduction of ventricular preload and afterload pressures

Cited by 2 publications

References 13 publications

Lower Body Negative Pressure: Historical Perspective, Research Findings, and Clinical Applications

Lower Body Negative Pressure: Historical Perspective, Research Findings, and Clinical Applications

A comparison of protocols for simulating hemorrhage in humans: step versus ramp lower body negative pressure

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