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Related Experiment Videos

Trendelenburg versus PASG application--hemodynamic response in man.

V E Pricolo, K W Burchard, A K Singh

    The Journal of Trauma
    |August 1, 1986
    PubMed
    Summary

    Pneumatic antishock garment (PASG) increases intrathoracic pressure, raising central venous pressure without improving cardiac output. Trendelenburg positioning, however, significantly boosts cardiac output by reducing systemic vascular resistance.

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    Area of Science:

    • Cardiovascular Physiology
    • Hemodynamics
    • Critical Care Medicine

    Background:

    • Diminished venous return is a key factor in reduced cardiac output during hemorrhagic hypoperfusion.
    • Pneumatic antishock garment (PASG) and Trendelenburg (TREND) positioning are used to enhance venous return.

    Purpose of the Study:

    • To compare the hemodynamic responses of PASG application and Trendelenburg positioning in normovolemic subjects.
    • To evaluate the effects of different PASG pressures on venous return and cardiac output.

    Main Methods:

    • Hemodynamic parameters were measured in normovolemic subjects under PASG application (20 and 40 mm Hg) and 10-degree Trendelenburg positioning.
    • Central venous pressure (CVP), left atrial pressure (LAP), pulmonary capillary wedge pressure (PCWP), esophageal pressure (Pes), and cardiac index (CI) were assessed.

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    Main Results:

    • PASG application significantly increased CVP, LAP, PCWP, and Pes, but did not alter transmural atrial pressures or cardiac index.
    • Trendelenburg positioning increased cardiac index but did not affect CVP, PCWP, or transmural atrial pressures.
    • Systemic vascular resistance index was lower with Trendelenburg positioning compared to PASG at 40 mm Hg.

    Conclusions:

    • PASG application elevates measured pressures secondary to increased intrathoracic pressure, without improving cardiac output.
    • Trendelenburg positioning effectively increases cardiac output and reduces systemic vascular resistance in normovolemic subjects.