Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Thijs, R. D.
Right arrow Articles by van Dijk, J. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Thijs, R. D.
Right arrow Articles by van Dijk, J. G.
Related Collections
Right arrow Autonomic diseases
Right arrow Multiple system atrophy
Right arrow Syncope
NEUROLOGY 2007;69:582-585
© 2007 American Academy of Neurology

Respiratory countermaneuvers in autonomic failure

Roland D. Thijs, MD, Wouter Wieling, MD, PhD, Joost G. van den Aardweg, MD, PhD and J. Gert van Dijk, MD, PhD

From the Department of Neurology and Clinical Neurophysiology (R.D.T., J.G.v.D.), Leiden University Medical Center, Leiden, Department of Internal Medicine (W.W.), Academic Medical Center, Amsterdam, and Department of Pulmonology (J.G.v.d.A.), Medical Center Alkmaar, the Netherlands.

Address correspondence and reprint requests to Dr Thijs, Department of Neurology and Clinical Neurophysiology, Leiden University Medical Centre, Postal Zone J3-R, PO Box 9600, 2300 RC Leiden, the Netherlands r.d.thijs{at}lumc.nl

Background: Selective increase of inspiratory impedance augments blood pressure in healthy subjects through activation of the respiratory pump. We studied the efficacy of respiratory maneuvers to reduce orthostatic hypotension in autonomic failure.

Methods: Mean arterial pressure (MAP) after standing up was recorded in 10 patients in five conditions: normal standing, leg muscle tensing, inspiratory pursed lips breathing, inspiratory sniffing, and a device causing inspiratory obstruction.

Results: The maneuvers caused significant differences in standing MAP. Inspiratory obstruction and leg muscle tensing increased MAP to a comparable degree. The effect of inspiratory pursed lips breathing and inspiratory sniffing depended on concomitant hyperventilation.

Conclusion: Respiratory maneuvers reduce orthostatic hypotension in autonomic failure through activation of the respiratory pump, provided hyperventilation is avoided.

Disclosure: The authors report no conflicts of interest. Statistical analysis was conducted by R.D.T.

Received November 30, 2006. Accepted in final form March 5, 2007.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by AAN Enterprises, Inc.