Medical (military) anti-shock trousers--a short review.

Randall, P E; Banks, Jonathan; Little, R. A.

doi:10.1136/emj.1.1.39

Cited by 12 publications

(13 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several advantages may be offered by the use of the sitting position for pineal region surgery such as: lower intracranial pressure, good venous outflow, gravitational retraction, and straight anatomical orientation. [ 2 7 10 17 18 21 22 26 32 ] On the other hand, the sitting position may oblige the surgeon to a nonergonomic tiring position, and may cause potential dreadful complications such as severe venous air embolism (VAE) associated to general hypotension. [ 1 14 25 29 ]…”

Section: Introductionmentioning

confidence: 99%

Venous air embolisms and sitting position in Helsinki pineal region surgery

Choque-Velasquez¹,

Colasanti²,

Resendiz-Nieves³

et al. 2018

Surg Neurol Int

View full text Add to dashboard Cite

Background:Nowadays, the sitting position has lost favor among neurosurgeons partly due to assumptions of increased complications, such as venous air embolisms (VAEs) and hemodynamic disturbances. The aim of our study is to describe the importance of some anesthetic considerations and the utility of antigravity trousers as well, together with a skillful neurosurgery and an imperative proper teamwork, in order to prevent the risk of severe VAE during pineal region surgery. We routinely use them for the variant of the sitting position we developed, the “praying position.”Methods:A retrospective review of 51 pineal lesions operated on in the “praying position” using antigravity trousers was carried out. In the “praying position” the legs of the patient are kept parallel to the floor. Hence, antigravity trousers are used to generate an adequate cardiac preload.Results:VAE associated to persistent hemodinamic changes was nonexistent in our series. The rate of VAE was 35.3%. VAEs were diagnosed mainly by monitoring of the end-tidal CO2 (83.33%). A venous system lesion was the cause in most of the cases. When VAE was suspected, an inmediate reaction based on a good teamwork was imperative. No cervical spine cord injury nor peripheral nerve damage were reported. The average microsurgical time was 48 ± 33 min.Conclusions:The risks of severe VAE during pineal region surgery in the “praying-sitting position” may be effectively prevented by some essential anesthetic considerations and the use of antigravity trousers together with a skillful neurosurgery, and an imperative proper teamwork.

show abstract

Section: Introductionmentioning

confidence: 99%

Venous air embolisms and sitting position in Helsinki pineal region surgery

Choque-Velasquez¹,

Colasanti²,

Resendiz-Nieves³

et al. 2018

Surg Neurol Int

View full text Add to dashboard Cite

show abstract

“…It is reasonable to expect that the blood displaced from the legs did not only distribute to the pulmonary circulation but also to other vascular networks in the upper body. Other authors suggested that a larger volume (750-1000 ml) of blood was displaced from the lower body, into the upper body (Randall et al 1984). However, their findings were in context of hemorrhagic patients, a severely impaired hemodynamic scenario which may not generalize in healthy volunteers.…”

Section: Discussionmentioning

confidence: 91%

Comparison of cardiac magnetic resonance imaging and bio-impedance spectroscopy for the assessment of fluid displacement induced by external leg compression

et al. 2016

View full text Add to dashboard Cite

Heart failure is marked by frequent hospital admissions, often as a consequence of pulmonary congestion. Current gold standard techniques for thoracic fluid measurement require invasive heamodynamic access and therefore they are not suitable for continuous monitoring. Changes in thoracic impedance (TI) may enable non-invasive early detection of congestion and prevention of unplanned hospitalizations. However, the usefulness of TI to assess thoracic fluid status is limited by inter-subject variability and by the lack of reliable normalization methods. Indicator dilution methods allow absolute fluid volume estimation; cardiac magnetic resonance (CMR) has been recently proposed to apply indicator dilution methods in a minimally-invasive manner. In this study, we aim to compare bio-impedance spectroscopy (BIS) and CMR for the assessment of thoracic fluid status, and to determine their ability to detect fluid displacement induced by a leg compression procedure in healthy volunteers. A pressure gradient was applied across each subject's legs for 5 min (100-60 mmHg, distal to proximal). Each subject underwent a continuous TI-BIS measurement during the procedure, and repeated CMR-based indicator dilution measurements on a 1.5 T scanner at baseline, during compression, and after pressure release. The Cole-Cole and the local density random walk models were used for parameter extraction from TI-BIS and indicator dilution measurements, respectively. Intra-thoracic blood volume index (ITBI) derived from CMR, and extracellular fluid resistance (R ) from TI-BIS, were considered as thoracic fluid status measures. Eight healthy volunteers were included in this study. An increase in ITBI of 45.2 ± 47.2 ml m was observed after the leg inflation (13.1 ± 15.1% w.r.t. baseline, p < 0.05), while a decrease of -0.84 ± 0.39 Ω in R (-1.7 ± 0.9% w.r.t. baseline, p< 0.05) was observed. ITBV and R normalized by body mass index were strongly inversely correlated (r = -0.93, p< 0.05). In conclusion, an acute fluid displacement to the thoracic circulation was induced in healthy volunteers. Significant changes were observed in the considered thoracic fluid measures derived from BIS and CMR. Good correlation was observed between the two measurement techniques. Further clinical studies will be necessary to prospectively evaluate the value of a combination of the two techniques for prediction of re-hospitalizations after admission for heart failure.

show abstract

“…Blood flow to the lower extremities may be preserved more so with the NASG than the PASG. For example, lower extremity ischemia and compartment syndrome have been reported with the PASG, but not with the NASG [16][17][18][19]. Future studies should endeavor to define these relationships and to more clearly elucidate the individual characteristics that affect NASG application.…”

Section: Discussionmentioning

confidence: 99%

The Non-pneumatic Anti-Shock Garment: How Applier Strength and Body Mass Index Affect External Abdominal Pressure

Stenson

Lester

Meyer

et al. 2011

TOWHJ

View full text Add to dashboard Cite

Abstract:Objective: To assess the amount of abdominal pressure generated by the Non-pneumatic Anti-Shock Garment (NASG), a first-aid counter pressure device for obstetric hemorrhage, and to evaluate if body mass index (BMI) and applier strength, affect pressure.Study Design: A pilot study convenience sample of 20 non-pregnant volunteers underwent external abdominal pressure monitoring with NASG placement. Mean pressure and the effects of BMI and applier strength were examined. Results:The mean external abdominal pressure significantly increased from 1.0 mmHg at baseline to 67 mmHg on NASG application, returning to 1.0 mmHg upon removal (p=0.005). Greater mean pressure was exerted by a strong applier versus a weak applier, irrespective of BMI (p<0.001). Pressure had an inverse relationship with BMI, particularly with a strong applier (r=-0.905, p<0.001). The difference between pressures achieved in an underweight patient with a strong applier and an overweight patient with a weak applier was significant (73.2 vs 35.7 mmHg; p=0.051). Conclusion:This pilot study demonstrates a significant increase in abdominal pressure with device application and significant variation with BMI and applier strength. These findings may have important implications for optimizing device usage.

show abstract

Medical (military) anti-shock trousers--a short review.

Cited by 12 publications

References 34 publications

Venous air embolisms and sitting position in Helsinki pineal region surgery

Venous air embolisms and sitting position in Helsinki pineal region surgery

Comparison of cardiac magnetic resonance imaging and bio-impedance spectroscopy for the assessment of fluid displacement induced by external leg compression

The Non-pneumatic Anti-Shock Garment: How Applier Strength and Body Mass Index Affect External Abdominal Pressure

Contact Info

Product

Resources

About