Idiopathic postural hypotension

With 1 Figure 0rthostatic or postural hypotension is a well-known complication of bilateral open surgical anterolaterM cordotomy for relief of pain 1, 6, 7, n, 13, 2~, ~6. This case is of interest, for it represents a follow-up on a patient treated by bilateral percutaneous eordotomy with effective relief of intractable pain from benign etiology but resulting in orthostatic hypotension requiring the use of an air pressure suit. It is this type of patient who might have responded best with the new technique of neuropacemaker implantation for dorsal column stimulation to effect pain relief.15"

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Use of lower abdominal compression to combat orthostatic hypotension in patients with autonomic dysfunction

Smit

et al. 2004

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The aim of this study was to investigate in patients with neurogenic orthostatic hypotension the mechanism and usefulness of abdominal compression to increase standing blood pressure. In three protocols, 23 patients underwent abdominal compression. Protocol 1 evaluated in a 40-60 degrees head-up-tilt position, the effect of abdominal compression on caval vein and femoral diameter, arterial blood pressure and hemodynamics. Protocol 2 documented the relationship between the level of compression and the arterial pressure response. Protocol 3 investigated the ability to maintain standing blood pressure by an elastic binder. During head-up-tilt, compression (40 mm Hg) resulted in a reduction in diameter of the caval vein (mean -2.6mm, range -1.4 to 0.6), without a change in femoral vein diameter. Stroke volume increased by 14 % (range -1 to 23) and blood pressure (systolic/diastolic) by 30/14 mmHg (range 7/2 to 69/36), both p< 0.05; 40 mmHg compression was associated with a higher pressure response than 20 mmHg (mean 18/8 mmHg, range 6/2 to 43/20 vs. mean 9/4 mmHg, range -1/0 to 18/8, p < 0.05). Elastic abdominal binding increased standing blood pressure with 15/6 mmHg (range -3/3 to 36/14, p < 0.05). We conclude that in patients with neurogenic orthostatic hypotension, abdominal compression increases standing blood pressure to a varying degree by increasing stroke volume.

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Idiopathic postural hypotension

Cited by 5 publications

References 12 publications

Cardiac Arrest on the Myelographic Tilt Table

Cardiac Arrest on the Myelographic Tilt Table

Orthostatic hypotension following bilateral percutaneous cordotomy

Use of lower abdominal compression to combat orthostatic hypotension in patients with autonomic dysfunction

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