The Clinical Aspects of Venous Pressure

Eyster, J. A. E.

doi:10.1097/00007611-192909000-00030

Cited by 18 publications

(11 citation statements)

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“…Several options have been suggested, but most frequently the mid-chest level [8,18], the 1/3 to 2/3 ratio of the thoracic diameter [7,21,22], the mid-axillary line [23][24][25] and the anterior axillary line [26,27] were used. Comparison studies found these approaches to provide more accurate ZRLs as compared to fixed distances from the anterior thorax surface or the spine [10].…”

Section: Pulmonary Vascular Diseases | G Kovacs Et Almentioning

confidence: 99%

“…According to the published literature, the ZRL is generally recommended to be set at the level of the right atrium, or at the level of the tricuspid valve, based on the concept of the ''hydrostatic indifferent point'' representing a location in the circulatory system at which gravitational pressure factors caused by changes in body position do not much affect the pressure measurements [5]. In practice, the most frequently used ZRLs in the supine patient are at 5 cm below the anterior thorax surface [6], at 1/3 of the thoracic diameter below the anterior thorax surface [7], at the midthoracic level [8] and 10 cm above table level [9]. Nevertheless, there are also arguments for setting the ZRL at the level of the left atrium, particularly if left heart pressures and the distinction between pre-and postcapillary PH are the focus of interest.…”

Section: Introductionmentioning

confidence: 99%

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Zero reference level for right heart catheterisation

Kovàcs

Avian²,

Olschewski³

et al. 2013

Eur Respir J

126

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Although in the pulmonary circulation small pressure differences may alter the categorisation of patients, there is no consensus on a standard zero reference level (ZRL). In the supine position, ZRL is mostly set at ''5 cm below anterior thorax surface'', ''1/3 thoracic diameter below anterior thorax surface'', ''mid-thoracic level'' or ''10 cm above table level''.We retrospectively assessed the distance of these four ZRLs from computed tomography-derived right and left atrial centre levels and from one another in patients undergoing right heart catheterisation and calculated the respective differences in pressure readings.We included 196 consecutive patients. The ZRL at ''1/3 thoracic diameter'' was most often (98.5%) level with the right atrium, and the ZRL at ''mid-thoracic level'' was level with the left atrium (97.4%), revealing a median (range) pressure difference of -0.3 (-3.0-1.3) and 0.2 (-2.0-1.3) mmHg from the right and left atrial centre level, respectively. The largest differences (8.0 (2.0-15.4) mmHg) were found between the ZRLs ''5 cm below anterior thorax surface'' and ''10 cm above table level''. Accordingly, 59% versus 80% of patients would be classified with pulmonary hypertension and 7% versus 38% with elevated left heart pressures.The choice of ZRL strongly influences pulmonary pressure readings and pulmonary hypertension classification. 1/3 thoracic diameter mostly represents the right atrium while the left atrium is best represented by the mid-thoracic level. @ERSpublications Choice of pulmonary circulation zero reference level influences classification of pulmonary hypertension

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Section: Pulmonary Vascular Diseases | G Kovacs Et Almentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Zero reference level for right heart catheterisation

Kovàcs

Avian²,

Olschewski³

et al. 2013

Eur Respir J

126

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“…after intravenous digoxin, k-strophanthosid or ouabain, showed usually no change of venous pressure, occasionally a slight fall. Cardiac adaptation to varying venous inflow is an important factor tending to stabilize venous pressure [Eyster, 1929]. In human congestive heart failure, the action of digitalis on the failing myocardium, and the effects of this in turn on venous pressure, probably obscures any effects which digitalis may have directly on the systemic veins.…”

Section: Methodsmentioning

confidence: 99%

A COMPARISON OF THE DIRECT PERIPHERAL ACTIONS UPON SYSTEMIC VENOUS PRESSURE OF k‐STROPHANTHOSID, DIGOXIN AND OUABAIN

Jh¹

1953

Exp Physiol

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IN a previous paper [Tyrer, 1952] evidence was presented that therapeutic concentrations of digoxin caused a rise of mean inferior vena caval pressure in sheep whose hearts had been replaced functionally by a double perfusion pump and whose pulmonary and systemic circulations were perfused at constant rates; this was considered unequivocal evidence of the existence of a direct peripheral action of digoxin upon systemic venous pressure. The present studies show the effects of digoxin, k-strophanthosid and ouabain on the mean superior and inferior vena caval and aortic pressures and on the mean hepatic venous and aortic pressures of sheep perfused at constant rates. The results were compared with the effects of these same drugs on the systemic venous pressure of control sheep with intact circulations.

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“…So far as we are aware this has not previously been done, though venous pressure during standing has been measured by many observers. These studies have been reviewed by Hooker and Eyster (1908), and by Eyster (1926Eyster ( ,1929. These papers contain positive indication that venous pressure is affected by muscular activity.…”

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confidence: 99%

A Method of Measuring Venous Pressure in the Human Leg During Walking¹

Beecher

Field

Krogh

1936

Skandinavisches Archiv Für Physiologie

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(With 2 figures in the text.)In studying the peripheral circulation we were confronted with the problem of measuring the venous pressure in the leg during walking. So far as we are aware this has not previously been done, though venous pressure during standing has been measured by many observers. These studies have been reviewed by Hooker and Eyster (1908), and by Eyster (1926Eyster ( ,1929. These papers contain positive indication that venous pressure is affected by muscular activity. For example, it has been shown in measuring standing venous pressure that unless precautions are taken to insure relaxation of the subject, the values will be too low. This can be explained only as the result of involuntary muscular activity pumping the blood out and reducing the pressure (Hooker, 1911;Carrier and Rehberg, 1923;McIntyre and Turner, 1935). That this pumping action would be increased during voluntary muscular activity was certain, but the extent of its effect in this case was not known; hence, it was important to measure the effect of this pumping action, if venous pressure determinations are to be useful in attacking problems of the peripheral circulation. Accordingly we have worked out the following method of measuring the venous pressure in a moving extremity.Various methods are used in determining standing venous pressure. All methods fall into one of two categories; direct or indirect, The data obtained by the two methods have been compared by 1 Der Redaktion am ZI. Oktober 1935 zugegangen.

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The Clinical Aspects of Venous Pressure

Cited by 18 publications

References 0 publications

Zero reference level for right heart catheterisation

Zero reference level for right heart catheterisation

A COMPARISON OF THE DIRECT PERIPHERAL ACTIONS UPON SYSTEMIC VENOUS PRESSURE OF k‐STROPHANTHOSID, DIGOXIN AND OUABAIN

A Method of Measuring Venous Pressure in the Human Leg During Walking¹

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The Clinical Aspects of Venous Pressure

Cited by 18 publications

References 0 publications

Zero reference level for right heart catheterisation

Zero reference level for right heart catheterisation

A COMPARISON OF THE DIRECT PERIPHERAL ACTIONS UPON SYSTEMIC VENOUS PRESSURE OF k‐STROPHANTHOSID, DIGOXIN AND OUABAIN

A Method of Measuring Venous Pressure in the Human Leg During Walking1

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A Method of Measuring Venous Pressure in the Human Leg During Walking¹