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Valsalva Maneuver

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1121. Differential Effects of Cough, Valsalva, and Continence Status on Vesical Neck Movement Full Text available with Trip Pro

Differential Effects of Cough, Valsalva, and Continence Status on Vesical Neck Movement We tested the null hypothesis that vesical neck descent is the same during a cough and during a Valsalva maneuver. We also tested the secondary null hypothesis that differences in vesical neck mobility would be independent of parity and continence status.Three groups were included: 17 nulliparous continent (31.3 +/- 5.6; range 22-42 years), 18 primiparous continent (30.4 +/- 4.3; 24-43), and 23 primiparous (...) vesical neck mobility during a cough effort and during a Valsalva maneuver (13.8 mm compared with 14.8 mm; P =.49). The nulliparous continent women (8.2 mm compared with 12.4 mm; P =. 001) and the primiparous continent women (9.9 mm compared with 14.5 mm; P =.002) displayed less mobility during a cough than during a Valsalva maneuver despite greater abdominal pressure during cough. The nulliparas displayed greater pelvic floor stiffness during a cough compared with the continent and incontinent

2000 Obstetrics and Gynecology

1122. Valsalva Maneuver Full Text available with Trip Pro

Valsalva Maneuver 16012118 2006 03 02 2018 11 13 1539-4182 3 2 2005 May Clinical medicine & research Clin Med Res Valsalva maneuver. 55; author reply 55 Hiner Bradley C BC eng Letter United States Clin Med Res 101175887 1539-4182 IM Autonomic Nervous System physiology Blood Pressure physiology Heart Rate physiology Humans Vagus Nerve physiology Valsalva Maneuver physiology 2005 7 14 9 0 2006 3 3 9 0 2005 7 14 9 0 ppublish 16012118 3/2/55 PMC1183428 Clin Med Res. 2005 Feb;3(1):35-8 15962020

2005 Clinical Medicine and Research

1123. Evaluating the efficacy of the valsalva maneuver on venous cannulation pain: a prospective, randomized study. (Abstract)

Evaluating the efficacy of the valsalva maneuver on venous cannulation pain: a prospective, randomized study. Pain associated with venous cannula is a distressing symptom. We evaluated the efficacy of the Valsalva maneuver on pain associated with venous cannulation. Seventy-five adults, ASA physical status I and II, either sex, undergoing elective surgery, were included in this study. Patients were randomized into 3 groups of 25 each. Group I (C): control; Group II (V): blew (...) , whereas 25 of 25 (100%) experienced pain in the other two groups (P < 0.001). A significant reduction in the severity of pain, number of patients in whom one needed to make the vein prominent before cannulation, and the time taken for the same were observed in the Valsalva group (P < 0.001).Venous cannulation is a necessary step for safe anesthesia administration; however, the pain associated with it is sometimes very distressing. We observed that the Valsalva maneuver performed at the time of venous

2005 Anesthesia and analgesia Controlled trial quality: uncertain

1124. The Valsalva maneuver: a bedside "biomarker" for heart failure. (Abstract)

The Valsalva maneuver: a bedside "biomarker" for heart failure. Accurate assessment of volume status remains an important clinical goal in the management of patients with heart failure. Although physical examination can provide clues to volume status, its sensitivity and reproducibility are limited. Other noninvasive methods, such as measurement of natriuretic peptides or the use of impedance cardiography, are not well validated. The cardiovascular response to the Valsalva maneuver had been (...) proposed as a simple, inexpensive bedside test for estimating filling pressures in patients with heart failure. Our objective was to summarize and critically evaluate the evidence for the use of the Valsalva maneuver in evaluating volume status in patients with heart failure. Studies have demonstrated a significant correlation between the cardiovascular response to the Valsalva maneuver and invasively measured ventricular filling pressures in patients with clinical heart failure. Although often

2006 American Journal of Medicine

1125. Cluster headache: orbital hemodynamic changes during Valsalva maneuver. (Abstract)

Cluster headache: orbital hemodynamic changes during Valsalva maneuver. The clinical features of cluster headache (CH) disclose some vascular changes in the symptomatic region, but few instrumental studies have assessed orbital hemodynamics in patients with this disorder.Orbital blood flow reactivity elicited by Valsalva maneuver (VM) was studied with ophthalmic artery eco-Doppler in 16 patients (14 men and 2 women; mean age: 41.2) suffering from episodic CH and in 18 healthy controls. Patients (...) amount of blood at the end of Valsalva. During remission, there might be some latent vascular changes that lead to supersensitive vasodilator responses and/or opening of arteriovenous shunts under certain circumstances such as Valsalva. These phenomena could be relevant in the pathophysiology of CH.

2006 Headache

1126. Vagal response varies with Valsalva maneuver technique: a repeated-measures clinical trial in healthy subjects. (Abstract)

Vagal response varies with Valsalva maneuver technique: a repeated-measures clinical trial in healthy subjects. Variable success rates of the Valsalva maneuver in treatment of paroxysmal supraventricular tachycardia may be due to variations in performance technique. This study aimed to compare the magnitude of the vagal reflexes initiated by 5 variations of the Valsalva maneuver technique (supine, supine with epigastric pressure, supine with leg raise, semirecumbent position, and sitting (...) position).This was a single-blinded, repeated-measures, clinical trial of 65 subjects in sinus rhythm. Subjects performed each Valsalva maneuver technique 5 times in random order. The means of the longest ECG R-R intervals during the relaxation phase (postmaneuver R-R interval) and the postmaneuver pulse rates for each technique were compared. The mean differences between the pre- and postmaneuver R-R intervals for each technique were also compared.The supine with epigastric pressure and supine

2004 Annals of Emergency Medicine Controlled trial quality: uncertain

1127. Cerebral hemodynamics during the Valsalva maneuver: insights from ganglionic blockade. Full Text available with Trip Pro

Cerebral hemodynamics during the Valsalva maneuver: insights from ganglionic blockade. The aim of this study was to differentiate the mechanical effects of the Valsalva maneuver (VM) from the effects of changes in autonomic neural activity on cerebral hemodynamics in humans.Nine healthy subjects performed the VM before and after autonomic ganglionic blockade with trimethaphan. Blood pressure (BP) was measured in the radial artery with an indwelling catheter or at the finger by Finapres

2004 Stroke

1128. Levator co-activation is a significant confounder of pelvic organ descent on Valsalva maneuver. Full Text available with Trip Pro

Levator co-activation is a significant confounder of pelvic organ descent on Valsalva maneuver. A Valsalva maneuver is used clinically and on imaging in order to determine female pelvic organ prolapse. We have examined the potential confounding effect of levator co-activation at the time of a Valsalva maneuver and the impact of repetition with biofeedback instruction.Fifty nulliparous women at 36-38 weeks' gestation received 3D/4D translabial ultrasound investigation in the dorsal resting (...) position after bladder emptying. Valsalva maneuvers were recorded initially and after repeated attempts with visual biofeedback both during the maneuver and after, with the operator demonstrating findings on the ultrasound monitor, in order to abolish levator co-activation. Offline analysis was subsequently undertaken.Significant differences between first and optimal Valsalva maneuver were found for bladder neck position, bladder neck descent, hiatal sagittal diameter and hiatal area on Valsalva

2007 Ultrasound in Obstetrics and Gynecology

1129. Dimensions of internal jugular veins in Turkish children aged between 0 and 6 years in resting state and during Valsalva maneuver. (Abstract)

Dimensions of internal jugular veins in Turkish children aged between 0 and 6 years in resting state and during Valsalva maneuver. We aimed to establish the values of the internal jugular vein (IJV) sizes in Turkish children aged between 0 and 6 years.Ninety-four normal children included in this study. All of the children were imaged by ultrasonography (USG) at the level of the cricoid cartilage. The maximal antero-posterior (AP) and transverse (T) diameters of the IJV were measured during (...) regular breathing and Valsalva maneuver.The mean transverse diameter of the right and left IJV were 8.11+/-3.01 and 7.64+/-2.68 mm in resting state. These values changed to 12.57+/-4.34 and 10.82+/-3.80 mm in Valsalva state, respectively. The AP diameters were found to be 5.43+/-2.07 for the right and 5.86+/-4.53 mm for the left IJV at rest. During VM, these values changed to 8.70+/-2.40 and 8.30+/-2.90 mm for the right and left IJV, respectively. There was no significant difference on the evaluation

2007 International Journal of Pediatric Otorhinolaryngology

1130. Blood pressure recovery from Valsalva maneuver in patients with autonomic failure. (Abstract)

Blood pressure recovery from Valsalva maneuver in patients with autonomic failure. Blood pressure (BP) changes in response to the Valsalva maneuver (VM) reflect the integrity of the baroreflex that regulates BP, and the phases of VM are widely used indices of adrenergic evaluation.To study the BP recovery time (PRT) following termination of VM back to baseline to determine if it could be an additional and better indicator of adrenergic function.The authors evaluated three groups of patients (...) correlations with phases II_L (reflex vasoconstriction following initial fall in BP) and IV (BP overshoot following the VM). PRT extends the indices for the quantitation of adrenergic failure, since it will continue to parallel increasing adrenergic failure after phase II_L is lost and is a reliable index when II_L cannot be recorded.Pressure recovery time is a valuable index of adrenergic failure. It extends the value of the Valsalva maneuver by providing a quantitative index that is measurable

2005 Neurology

1131. Arterial pressure changes during the Valsalva maneuver to predict fluid responsiveness in spontaneously breathing patients. (Abstract)

Arterial pressure changes during the Valsalva maneuver to predict fluid responsiveness in spontaneously breathing patients. To evaluate whether arterial pressure response during a Valsalva maneuver could predict fluid responsiveness in spontaneously breathing patients.Prospective clinical study in a 17-bed multidisciplinary intensive care unit.Thirty patients without mechanical ventilation and equipped with a radial arterial catheter for whom the decision to give fluids was taken due (...) to suspected hypovolemia.A 10-s Valsalva maneuver was performed before and after volume expansion (VE). Patients were classified as responders if stroke volume index (SVi) increased >/=15% after VE.Pulse pressure changes during the Valsalva maneuver (VPP) were calculated as the difference between maximal pulse pressure during phase 1 and minimal pulse pressure during phase 2 of the Valsalva maneuver divided by the mean of the two values and expressed as a percentage. Valsalva changes in systolic pressure

2008 Intensive Care Medicine

1132. In-flight Valsalva maneuver induced life-threatening Wünderlich syndrome. (Abstract)

In-flight Valsalva maneuver induced life-threatening Wünderlich syndrome. Valsalva maneuver, a preferred method for induction of a complex cardiovascular response, is often performed to relieve ear block during descent in aviation. We described a rare case of Wünderlich syndrome presenting with characteristic clinical and imaging features of ruptured renal angiomyolipoma (AML) induced by a Valsalva maneuver. Renal AML heralded by unbridled hemorrhage is a disastrous entity that can be easily

2008 American Journal of Emergency Medicine

1133. Trendelenburg position, simulated Valsalva maneuver, and liver compression do not alter the size of the right internal jugular vein in patients with a bidirectional Glenn shunt. (Abstract)

Trendelenburg position, simulated Valsalva maneuver, and liver compression do not alter the size of the right internal jugular vein in patients with a bidirectional Glenn shunt. Ultrasound is increasingly used to facilitate right internal jugular vein (RIJV) cannulation in children. In children without cardiac disease, position changes and enhancement maneuvers increase RIJV cross-sectional area (CSA) and further facilitate cannulation. We investigated the effect of these maneuvers on RIJV CSA (...) in children with a bidirectional Glenn (BDG) shunt presenting for a Fontan procedure.The CSA (cm(2)) of the RIJV in 21 children with a BDG shunt presenting for a Fontan procedure was assessed by ultrasonic planimetry (SonoSite). Two positions, supine (S) and 15 degrees Trendelenburg (T); and two enhancements maneuvers, manual liver compression (L) and a simulated Valsalva maneuver (V) were utilized in combination. Eight separate measurements (S, S + L, S + V, S + L + V, T, T + L, T + V, T + L + V) were

2007 Anesthesia and Analgesia

1134. Humming is as effective as Valsalva's maneuver and Trendelenburg's position for ultrasonographic visualization of the jugular venous system and common femoral veins. (Abstract)

Humming is as effective as Valsalva's maneuver and Trendelenburg's position for ultrasonographic visualization of the jugular venous system and common femoral veins. The purpose of this study is to compare ultrasonographic visualization of the jugular and common femoral veins by using a novel technique (humming) and 2 conventional techniques (Valsalva's maneuver and Trendelenburg's position). The Valsalva's maneuver and Trendelenburg's position are common methods for producing venous distention (...) , aiding ultrasonographically guided identification and cannulation of the jugular and common femoral veins. We hypothesize that humming is as effective as either Valsalva's maneuver or Trendelenburg's position for distention and ultrasonographic visualization of these procedurally important blood vessels. Herein, we investigate a new method of venous distension that may aid in the placement of central venous catheters by ultrasonographic guidance.Healthy, normal volunteers aged 28 to 67 years were

2007 Annals of Emergency Medicine

1135. Effect of position on cardiovascular response during the Valsalva maneuver. (Abstract)

Effect of position on cardiovascular response during the Valsalva maneuver. Sudden cardiac death (SCD) has frequently been associated with the Valsalva maneuver (VM), which is characterized by sudden intense changes in systolic blood pressure (SBP) and heart rate (HR). The purpose of this study was to examine the effect of manipulating body position on the intensity of SBP and HR changes during the VM. Thirty-two men and 32 women (35-55 years) without a history or signs of cardiovascular

1990 Nursing research

1136. Use of Valsalva's maneuver to detect early recurrence of congestive heart failure in a randomized trial of furosemide withdrawal in older patients. (Abstract)

Use of Valsalva's maneuver to detect early recurrence of congestive heart failure in a randomized trial of furosemide withdrawal in older patients. 10573455 1999 12 07 2013 11 21 0002-8614 47 11 1999 Nov Journal of the American Geriatrics Society J Am Geriatr Soc Use of Valsalva's maneuver to detect early recurrence of congestive heart failure in a randomized trial of furosemide withdrawal in older patients. 1384-5 van Kraaij D J DJ Jansen R W RW Bouwels L H LH Go R I RI Verheugt F W FW (...) Valsalva Maneuver Ventricular Pressure physiology 1999 11 26 1999 11 26 0 1 1999 11 26 0 0 ppublish 10573455

1999 Journal of the American Geriatrics Society Controlled trial quality: uncertain

1137. Reduced time for femoral venipuncture by simple bedside application of Valsalva maneuver (the poor cardiologist's smart needle). (Abstract)

Reduced time for femoral venipuncture by simple bedside application of Valsalva maneuver (the poor cardiologist's smart needle). 8184843 1994 06 16 2004 11 17 0002-9149 73 13 1994 May 15 The American journal of cardiology Am. J. Cardiol. Reduced time for femoral venipuncture by simple bedside application of Valsalva maneuver (the poor cardiologist's smart needle). 1023-4 Bombardini T T Istituto di Fisiologia Clinica, CNR, Pisa, Italy. Picano E E Magagnini E E eng Clinical Trial Journal Article (...) Randomized Controlled Trial United States Am J Cardiol 0207277 0002-9149 AIM IM Adult Aged Bloodletting methods Catheterization methods Femoral Vein Humans Male Middle Aged Valsalva Maneuver 1994 5 15 1994 5 15 0 1 1994 5 15 0 0 ppublish 8184843 0002-9149(94)90165-1

1994 The American journal of cardiology Controlled trial quality: uncertain

1138. A noninvasive evaluation of baroreceptor sensitivity with the Valsalva maneuver and phenylephrine methods. (Abstract)

A noninvasive evaluation of baroreceptor sensitivity with the Valsalva maneuver and phenylephrine methods. In a double-blind crossover study, we compared baroreceptor sensitivity (BS) and latency, derived from the phenylephrine method with BS and latency derived from phase IV of the Valsalva maneuver (VM), using the Finapres, a noninvasive blood pressure monitor. Ten healthy volunteers were enrolled in the study and BS was determined with placebo, atropine (0.03 mg/kg) and atenolol (10 mg (...) by the Valsalva maneuver with placebo and atropine, but not with atenolol, suggests a parasympathetically influenced vasodilation, and sympathetically medicated tachycardia during phase IV of the VM.

1996 Methods and findings in experimental and clinical pharmacology Controlled trial quality: uncertain

1139. Effects of hypovolemia and posture on responses to the Valsalva maneuver. (Abstract)

Effects of hypovolemia and posture on responses to the Valsalva maneuver. We tested the hypotheses that hypovolemia would result in attenuated elevation in blood pressure, greater baroreflex-mediated tachycardia, and reduced capacity for vasoconstriction during a Valsalva maneuver (VM).Heart rate (HR) and mean arterial pressure (MAP) were measured beat-by-beat before strain, during a 15-s VM strain at 30 mmHg expiratory pressure, and post-strain. Eight subjects performed three VM trials in each (...) ), but not by circulating blood volume. Therefore, our results did not support our hypothesis that hypovolemia would result in attenuated elevation in blood pressure, greater baroreflex-mediated tachycardia, and reduced capacity for vasoconstriction during a Valsalva maneuver. However, moderate hypovolemia can be specifically predicted by the phase I response to a VM performed in the standing posture.

1996 Aviation, space, and environmental medicine Controlled trial quality: uncertain

1140. Comparison of treatment of supraventricular tachycardia by Valsalva maneuver and carotid sinus massage. (Abstract)

Comparison of treatment of supraventricular tachycardia by Valsalva maneuver and carotid sinus massage. To compare the efficacy of the Valsalva maneuver with that of carotid sinus massage (CSM) in terminating paroxysmal supraventricular tachycardia (SVT) in the ED.This prospective, randomized case study was performed in the ED of a tertiary care institution. Patients were at least 10 years of age with regular narrow complex tachycardia and had an ECG diagnosis of SVT. Patients with regular (...) narrow complex tachycardia were randomly assigned to undergo either the Valsalva maneuver or CSM. If the tachycardia was not terminated by the method chosen by randomization, then the alternative method of vagal maneuver was used. If the tachycardia was not converted by both methods of vagal stimulation, patients would undergo either synchronized electrical cardioversion or a pharmacologic method of conversion at the discretion of the treating physician, depending on the patient's hemodynamic

1998 Annals of Emergency Medicine Controlled trial quality: uncertain

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