AI Article Synopsis
- The study investigated how the Valsalva manoeuvre affects several cardiovascular measures, including heart rate, central venous pressure (CVP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP), and cerebellar blood flow (CBF).
- During the manoeuvre's phases 2 and 3, a significant decrease in CPP was observed, resulting in CBF dropping to around 57-59% of baseline levels.
- Although the MAP, CPP, and CBF returned to normal after phase 4, the findings indicate that while Valsalva manoeuvres can help in venous control during surgeries, they can also cause significant changes in blood circulation that need to be monitored carefully.
Article Abstract
We examined the effects of Valsalva's manoeuvre and its four phase on heart rate, central venous pressure (CVP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP), and laser Doppler cerebellar cortical blood flow (CBF). Brief Valsalva manoeuvres increased CVP and markedly decreased MAP. Cerebral perfusion pressure significantly (P < or = 0.01, Dunnett's test) decreased during phases 2 and 3 of the Valsalva manoeuvre. Cortical blood flow closely paralleled CPP; CBF decreased to 59% of control during phase 2 and to 57% of control during phase 3 of the Valsalva manoeuvre. The MAP, CPP, and CBF all returned to baseline levels during phase 4 (the overshoot phase) of the Valsalva manoeuvre, and were not significantly greater than control. No autoregulatory change in cerebrovascular resistance occurred throughout the Valsalva manoeuvre. These results suggest that brief Valsalva manoeuvres, as employed during neurosurgical procedures, mainly confirm venous haemostasis, but must be used cautiously due to the marked haemodynamic changes.
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