This study is designed to evaluate the various physiologic maneuvers (Valsalva, humming, breath-hold) for the potential prevention of air embolism during central venous catheter placement. Central venous pressure measurements were prospectively obtained in 40 patients undergoing central venous catheter placement. The average central venous pressure at baseline was 3.275 mm Hg (range = -4 to 16, SD = 5.99). The average central venous pressure during breath hold was 6.1 mm Hg (range = -6 to 24, SD = 7.99). The average central venous pressure during humming was 5.1 mm Hg (range = -4 to 20, SD = 6.4) The average central venous pressure during the Valsalva maneuver was 18.43 (range = -3 to 48, SD = 14.73). Forty percent of patients (16 of 40) had negative central venous pressures at rest, 25% (10 of 40) had negative pressures during breath hold, 20% (8 of 40) had negative pressures during humming, and 2.5% (1 of 40) had negative pressures during Valsalva maneuver. The average increases in central venous pressure during breath hold, humming, and Valsalva were 2.85, 1.82, and 15.2 mm Hg, respectively. The difference between pressures during Valsalva and other maneuvers was statistically significant (P <.05). The conclusion is that the Valsalva maneuver is superior to breath-hold and humming for increasing central venous pressure during central venous catheter placement and, therefore, it is more likely to prevent air embolism in cooperative patients.

译文

:这项研究旨在评估各种生理动作(Valsalva,嗡嗡声,屏气),以潜在地防止在中心静脉导管放置过程中发生空气栓塞。前瞻性测量了40名接受中心静脉导管置入的患者的中心静脉压。基线时的平均中心静脉压为3.275毫米汞柱(范围= -4至16,SD = 5.99)。屏气期间的平均中心静脉压为6.1 mm Hg(范围= -6至24,SD = 7.99)。嗡嗡声期间的平均中心静脉压为5.1 mm Hg(范围= -4至20,SD = 6.4)。Valsalva动作期间的平均中心静脉压为18.43(范围= -3至48,SD = 14.73)。 40%的患者(40名患者中有16名)在休息时中心静脉负压,25%(40名患者中的10名)屏气时负压,20%(40名患者中的8名)哼唱时负压,2.5%(1名患者)。 40)在瓦尔萨尔瓦(Valsalva)演习中有负压。屏气,嗡嗡声和Valsalva期间中心静脉压的平均升高分别为2.85、1.82和15.2 mm Hg。瓦尔萨尔瓦(Valsalva)和其他动作之间的压力差异具有统计学意义(P <.05)。结论是,在中央静脉导管置入过程中,Valsalva的操作在增加中央静脉压力方面优于屏气和嗡嗡作响,因此,它更有可能在合作患者中预防空气栓塞。

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