Study in influence of different body postures on the measurement of central venous pressure for patients after upper abdominal surgery
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Objective To explore the changes on the value of CVP with different body postures after upper abdominal surgery in order to provide accurate basis for better monitoring of central venous pressure(CVP). Methods The CVP, blood pressure,pulse,respiration of 43 patients after upper abdom-inal surgery with indwelling central venous catheter were measured under supine position, 15°dorsal ele-vated position and 30°dorsal elevated position.The data were collected for correlation and regression analysis. Results The CVP value increased with the elevation of body postures,the CVP value under supine position was linearly positively correlated with the other two positions(P<0.01).The regression e-quation of supine position and 15°dorsal elevated position was:Y=1.009X1+0.811; the regression equation of supine position and 30°dorsal elevated position was:Y=1.005X2+1.630. Conclusions Through moni-toring the CVP value under 15°dorsal elevated position and 30°dorsal elevated position,and substitute it in equation,we can evaluate the CVP value under supine position.
Key words:
Central venous pressure; Body postures; MeasurementKeywords:
Supine position
Position (finance)
Body position
Venous return curve
Objective To explore the blood pressure values during changing from supine position to various lateral positions.Methods Systolic blood pressure(SBP) and diastolic blood pressure(DBP) of left upper limb at brachial artery of 60 ICU patients were taken at such various positions as supine,30-degree and 90-degree right lateral,respectively.Results SBP and DBP values of left upper limbs descended step by step from supine,30-degree and 90-degree right lateral position,and there were significant diffe-rences in SBP and DBP values taken at the 3 positions(P0.01 for all).Conclusion As the angle of lateral position increased,the SBP and DBP values changed significantly.As regard to bedbound patients,particularly those in critical condition who need conti-nuous BP monitoring,the effect of lateral decubitus angle on blood pressure value should be paid more attentionto.
Supine position
Brachial artery
Degree (music)
Position (finance)
Body position
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Objective:To investigate whether invasive boold pressure measurement of lateral position and supine position was different or not.Methods:Boold pressure measurement of supine position,right lateral position and left lateral position was measured in 30 patients,with invasive boold pressure monitoring by the femoral arteries of right under limbs.Results:The mean systolic pressure of supine position was 135.63±21.47 mmHg,that of right lateral position was 133.67±26.18 mmHg.There was no significant difference in the two groups,P0.05.The mean systolic pressure of left lateral position was 123.33±26.67mmHg,which was significant difference with that of supine position,P0.05.The mean diastolic pressure of supine position was 76.23±13.94mmHg,that of right lateral position was 76.16±13.04mmHg,There was no significant difference in the two groups,P0.05.the mean diastolic pressure of left lateral position was 65.80±12.89mmHg,which was significant difference with that of supine position,P0.01.Conclusion:When the right femoral arteries were used for invasive boold pressure monitoring of different positions,there was no significant difference between right lateral position and supine position.The mean systolic pressure of left lateral position was 12.30mmHg lower than that of supine,and the mean diastolic pressure was 10.43mmHg lower.
Supine position
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Objective:To investigate whether noninvasive blood pressure measurement of lateral position and supine position was different or not.Methods:Blood pressure measurement of supine position,right lateral position and left lateral position was measured in 150 patients,with noninvasive blood pressure monitoring by the brachial arteries of right upper limbs.Results:The mean systolic pressure of supine position was 128 13±18 97mmHg,that of right lateral position was 127 31±19 60mmHg.There was no significant difference in the two groups, P 0 05.The mean systolic pressure of left lateral position was 113 66±17 69mmHg,which was significant difference with that of supine position, P 0 01.The mean diastolic pressure of supine position was 76 02±12 30mmHg,that of right lateral position was 77 67±12 15mmHg.There was no significant difference in the two groups, P 0 05.The mean diastolic pressure of left lateral position was 61 85±12 21mmHg,which was significant difference with that of supine position, P 0 01.Conclusion:When the brachial arteries of right upper limbs were used for noninvasive blood pressure monitoring of different positions,there was no significant difference between right lateral position and supine position.The mean systolic pressure of left lateral position was 14 47mmHg lower than that of supine,and the mean diastolic pressure was 14 17mmHg lower.
Supine position
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Body position
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Objective To compare the difference on determination of right hand of humerus blood pressure between supine and lateral position.Methods The right hand of humerus blood pressure were determined in supine and lateral position in two hundreds of volunteers respectively.Results The systolic blood pressure(mmHg) in supine position was about(119±3.2)and that in left and right recumbent position were about(108±2.5)and(118±3.1) respectively,the corresponding values of diastolic blood pressure(mmHg) were about(79±4.1),(61±3.1) and(78±2.4) respectively.The data of blood pressure determined in supine position were significantly greater than those in left recumbent position.Conclusion The data of blood pressure determined in supine position were significantly greater than those in left recumbent position in healthy volunteers.
Supine position
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Body position
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Jugular vein
Central venous catheter
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Objective To discuss the zero point position of central venous pressure(CVP) by determining the difference of CVP under 45°,90°lateral position and supine position. Methods The CVP of 50 cases performed elective surgery undergoing tracheal intubation anesthesia were measured of lateral position and supine position at the same time,the position of the sensor in the chest wall was marked when the CVP values was the same in the two positions by means of moving the sensors,while changes of BP,HR,SpO2,RR were recorded. Results The CVP under right 45°,90° and left 90° lateral position were statistically significant than that under supine position,the CVP under left 45° lateral position was not significanfly different from that under supine position.The zero point under right 45°,90°and left 45°,90°lateral position situated at the left side of the right anterior axillary line (0.8 ± 0.4)cm,the upper side of the right sterna border line (0.8 ± 0.2)cm,the right side of the left anterior axillary line (0.3 ± 0.2)cm,the lower side of the left sternal border line (2.2 ± 0.3)cm. Conclusions The zero point position determined by monitoring the changes of CVP under lateral position can not only comfortably measure CVP but also avoid discomfort and complications in patients by forced supine position.
Key words:
Lateral position; Central venous pressure; Zero point position
Supine position
Position (finance)
Prone position
Axillary lines
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Objective To investigate whether ambulatory blood pressure monitoring of lateral position,supine position,sitting position and standing position was different or not in patients with hypertension.Methods Blood pressure measurement of supine position,left lateral position,right lateral position,sitting position and standing position was measured in 51 hypertension patients,with ambulatory blood pressure monitoring by the brachial artery of right upper limb.Results The mean systolic pressure of supine position was 152.10±14.55mm Hg,that of left lateral position was 129.21±14.92mm Hg.There was significant difference in the two groups,P0.01.The mean systolic pressure of right lateral position,sitting position and standing position was separately 150.42±15.54mm Hg,149.87±14.84mm Hg and 147.85±12.67mm Hg,which were no significant difference with that of supine position,P0.05.The mean diastolic pressure of supine position was 87.81±6.92mm Hg,that of left lateral position was 70.83±8.32mm Hg.There was significant difference in the two groups,P0.01.The mean diastolic pressure of right lateral position,sitting position and standing position was separately 88.33±11.52mm Hg,88.81±9.15mm Hg and 87.25±11.15mm Hg,which were no significant difference with that of supine position,P0.05.Conclusion There was no significant difference between supine position and right lateral position,sitting position or standing position in ambulatory blood pressure monitoring of different positions.The mean systolic pressure and diastolie pressure of left lateral position were lower than those of supine.
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Cardiac output was measured by thermodilution in 51 adult postcardiac surgical patients using three positions, supine, right lateral, and left lateral, each with 20° backrest elevation. Measurements were taken 4 to 24 hours (M = 10.58) after surgery. Mean cardiac output was significantly different in the three positions, p = .03. This difference resulted from changes in stroke volume, p = .004, rather than changes in heart rate, p = .12. The largest variation occurred between cardiac outputs measured in the supine position and those measured in the left lateral position. Patients at greatest risk for variations in cardiac output with lateral postural change were those with a cardiac index less than 2.3 L/min/m2, those in whom the time elapsed since surgery was less than 12 hours, and those receiving either vasoactive drugs or mechanical ventilation. These results suggest that nurses need to measure cardiac output using a supine position to control for physiological changes that may occur with lateral postural change.
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Hemodynamic measurements in human subjects and in experimental animals are generally made in the supine position; not much attention is paid to potential beneficial or harmful effects of right or left lateral positions on cardiac output or other hemodynamic variables. To evaluate the potential influence of such positional changes on cardiac performance, we measured cardiac output and left and right ventricular pressures (with micromanometer catheters) in anesthetized experimental animals (eight dogs and nine pigs) in the supine, right lateral, and left lateral positions. Cardiac output increased from supine to left lateral (mean +/- SD, 2.6 +/- 0.9 to 3.1 +/- 1.0 liters/min; p less than .001) and from supine to right lateral positions (2.6 +/- 0.9 to 3.1 +/- 1.1 liters/min; p less than .001). There was an associated decrease in arteriovenous oxygen saturation difference from supine to left lateral position (31 +/- 8% to 24 +/- 4%; p less than .001) and from supine to right lateral position (32 +/- 9% to 25 +/- 6%; p less than .001). Left ventricular systolic and end-diastolic pressures increased from supine to left lateral (128 +/- 17/9 +/- 2 to 147 +/- 19/16 +/- 4 mm Hg; both p less than .001) and from supine to right lateral positions (128 +/- 19/9 +/- 2 to 141 +/- 16/16 +/- 7 mm Hg; p less than .01 and p less than .001, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
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