Valsalva maneuver: shortest optimal expiratory strain duration.

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Citation: Journal of Community Hospital Internal Medicine Perspectives. 1(2), 2011.PMID: 23882329Department: Medicine | MedStar MedStar Union Memorial HospitalForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2011ISSN:
  • 2000-9666
Name of journal: Journal of community hospital internal medicine perspectivesAbstract: CONCLUSIONS: ES duration of 10 seconds created a low level of difficulty in healthy individuals. This strain duration produced consistent hemodynamic response for all parameters tested except IIL phase. The absence of IIL phase with 10 seconds ES should not be interpreted as an indicator of sympathetic vasoconstrictor failure.METHODS: Thirty-four healthy subjects performed the Valsalva maneuver (VM) with an ES duration of 10, 12, and 15 seconds in random order. Level of difficulty after each trial was rated 1 to 10, with 10 being the most difficult. Blood pressure and heart rate (HR) were recorded continuously and non-invasively. Parameters studied were Valsalva ratio (VR), early phase II (IIE), late phase II (IIL), tachycardia latency (TL), bradycardia latency (BL), and overshoot latency (OV-L). Consistency of responses was calculated.PURPOSE: To quantitate the level of difficulty and determine consistency of hemodynamic responses with various expiratory strain (ES) durations.RESULTS: DIFFICULTY INCREASED SIGNIFICANTLY WITH INCREASED ES DURATION: 5.1+/-0.1 (mean+/-SEM) at 10 seconds, 5.9+/-0.1 at 12 seconds, and 6.8+/-0.1 at 15 seconds (p<0.001). Phase IIE, TL, BL, OV-L, and VR response did not differ statistically with increasing ES durations, and there were no differences in variability. Phase IIL response increased significantly with increasing ES duration. Phase IIL was poorly delineated in 14 of 102 trials with 10 seconds ES duration.All authors: Dubin NH, Khurana RK, Mittal DFiscal year: FY2011Digital Object Identifier: Date added to catalog: 2020-12-29
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Journal Article MedStar Authors Catalog Article 23882329 Available 23882329

CONCLUSIONS: ES duration of 10 seconds created a low level of difficulty in healthy individuals. This strain duration produced consistent hemodynamic response for all parameters tested except IIL phase. The absence of IIL phase with 10 seconds ES should not be interpreted as an indicator of sympathetic vasoconstrictor failure.

METHODS: Thirty-four healthy subjects performed the Valsalva maneuver (VM) with an ES duration of 10, 12, and 15 seconds in random order. Level of difficulty after each trial was rated 1 to 10, with 10 being the most difficult. Blood pressure and heart rate (HR) were recorded continuously and non-invasively. Parameters studied were Valsalva ratio (VR), early phase II (IIE), late phase II (IIL), tachycardia latency (TL), bradycardia latency (BL), and overshoot latency (OV-L). Consistency of responses was calculated.

PURPOSE: To quantitate the level of difficulty and determine consistency of hemodynamic responses with various expiratory strain (ES) durations.

RESULTS: DIFFICULTY INCREASED SIGNIFICANTLY WITH INCREASED ES DURATION: 5.1+/-0.1 (mean+/-SEM) at 10 seconds, 5.9+/-0.1 at 12 seconds, and 6.8+/-0.1 at 15 seconds (p<0.001). Phase IIE, TL, BL, OV-L, and VR response did not differ statistically with increasing ES durations, and there were no differences in variability. Phase IIL response increased significantly with increasing ES duration. Phase IIL was poorly delineated in 14 of 102 trials with 10 seconds ES duration.

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