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Trendelenburg position and oxygen transport in hypovolemic adults
R F Sing1, D O'Hara, M A Sawyer
1Department of Surgery, Graduate Hospital, Philadelphia.
Study Objective:
To evaluate the effect of the Trendelenburg position on oxygen transport in hypovolemic patients.
Design:
A prospective, self-controlled sequential design.
Interventions:
All patients had indwelling pulmonary artery catheters, and hypovolemia was confirmed by a pulmonary artery wedge pressure of 6 mm Hg or less. Hemodynamic and oxygen transport variables were measured with the patient supine and again ten minutes after placing the patient in the Trendelenburg position.
Setting:
University-affiliated tertiary care surgical ICU.
Type Of Participants:
Eight postoperative adults.
Results:
Mean arterial blood pressure increased from 64.9 +/- 4.9 to 75.6 +/- 3.5 mm Hg (P < .05), pulmonary artery wedge pressure increased from 4.6 +/- 1.1 to 7.9 +/- 0.8 mm Hg (P < .05), and the systemic vascular resistance rose to 2,965 +/- 210 from 2,302 +/- 199 dyne.sec/cm5 (P < .05). There was no significant change in cardiac index, oxygen delivery, oxygen consumption, or oxygen extraction ratio.
Conclusion:
The increase in blood pressure from Trendelenburg position is not associated with an improvement in blood flow or tissue oxygenation.
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