Combined counter-maneuvers accelerate recovery from orthostatic hypotension in familial dysautonomia

Acta Neurologica Scandinavica
M J HilzF B Axelrod

Abstract

In patients with familial dysautonomia (FD), prominent orthostatic hypotension (OH) endangers cerebral perfusion. Supine repositioning or abdominal compression improves systolic and diastolic blood pressure (BPsys and BPdia). To determine whether OH recovers faster with combined supine repositioning and abdominal compression than with supine repositioning alone. In 9 patients with FD (17.8 ± 3.9 years) and 10 healthy controls (18.8 ± 5 years), we assessed 2-min averages of BPsys, BPdia, and heart rate (HR) during supine rest, standing, supine repositioning, another supine rest, second standing, and supine repositioning with abdominal compression by leg elevation and flexion. We determined BPsys- and BPdia-recovery-times as intervals from return to supine until BP reached values equivalent to each participant's 2-min average at supine rest minus two standard deviations. Differences in signal values and BP-recovery-times between groups and positions were assessed by ANOVA and post hoc testing (significance: P < 0.05). Patients with FD had pronounced OH that improved with supine repositioning. However, BP only reached supine rest values with additional abdominal compression. In controls, BP was stable during positional changes. Wi...Continue Reading

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Citations

Nov 23, 2013·Oral and Maxillofacial Surgery·Walessa Brasil da SilvaSérgio de Melo Alves-Junior
Oct 18, 2014·Expert Opinion on Pharmacotherapy·Jose-Alberto PalmaHoracio Kaufmann
Dec 3, 2014·Archives of Physical Medicine and Rehabilitation·Patricia Branco MillsAndrei Krassioukov

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