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Trendelenburg versus PASG application in moderate hemorrhagic hypoperfusion
The Journal of Trauma
|October 1, 1985
Summary
Trendelenburg positioning may be a superior therapy for hemorrhagic hypoperfusion compared to pneumatic antishock garment (PASG) application. Trendelenburg maintained cardiac output, while PASG depressed it, impacting hemodynamic response.
Area of Science:
- Emergency Medicine
- Physiology
Background:
- Hemorrhagic hypoperfusion requires interventions to maintain hemodynamic stability.
- Pneumatic antishock garment (PASG) and Trendelenburg positioning are used to augment venous return and cardiac output.
Purpose of the Study:
- To compare the hemodynamic responses to PASG application versus Trendelenburg positioning in a model of hemorrhagic hypoperfusion.
Main Methods:
- Anesthetized dogs underwent controlled hemorrhage (24% blood volume).
- Interventions included PASG application (30 +/- 5 mm Hg) or Trendelenburg positioning.
- Hemodynamic parameters, including cardiac index and systemic vascular resistance, were monitored.
Main Results:
- Both PASG and Trendelenburg maintained mean arterial pressure.
- PASG application depressed cardiac index and increased systemic vascular resistance.
- Trendelenburg positioning maintained cardiac index and did not significantly increase systemic vascular resistance.
Conclusions:
- Trendelenburg positioning may be superior to PASG for treating moderate hemorrhagic hypoperfusion.
- Trendelenburg preserves mean arterial pressure by maintaining cardiac output.
- PASG preserves mean arterial pressure primarily by increasing systemic vascular resistance.