BACKGROUND There are concerns about the harmful effects of the Valsalva maneuver during the second stage of labor. OBJECTIVES Comparing the effects of spontaneous pushing in the lateral position with the Valsalva maneuver during the second stage of labor on maternal and fetal outcomes. METHODS Inclusion criteria in this randomized clinical trial conducted in Iran were as follows: nulliparou...

A short cut review was carried out to establish whether the use of the Trendelenburg position improves the rate of cardioversion in supraventricular tachycardias (SVTs). 54 papers were found of which 3 presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of the...

A computer assisted apparatus for the continuous measurement of azygos blood flow is described. The system was validated in vitro and changes in flow which occur with respiration and Valsalva manoeuvre are illustrated. This apparatus allows real time inspection of flow values which enables changes in flow over short periods to be readily studied.

Interactions between the cardiovascular responses to the Valsalva manoeuvre and sustained handgrip were analysed in 5 men with untreated mild hypertension and 4 young normal subjects. Though set at a higher level, there was a normal blood pressure response to the Valsalva manoeuvre during concurrent sustained handgrip in 4 of the 5 hypertensive subjects. At the end of the handgrip period in whi...

Measurements of cerebral spinal fluid pressure, arterial pressure, and internal carotid artery blood flow were obtained in a series of patients during a Valsalva maneuver. During straining (phase II), an 11% reduction in mean arterial pressure was associated with a 21% decrease in internal carotid flow from control values; and following release (phase IV), the 19% increase in mean arterial pres...

Patients with Parkinson disease often have orthostatic hypotension. Neurocirculatory abnormalities underlying orthostatic hypotension might reflect levodopa treatment. Sixty-six Parkinson disease patients (36 with orthostatic hypotension, 15 off and 21 on levodopa; 30 without orthostatic hypotension) had tests of reflexive cardiovagal gain (decrease in interbeat interval per unit decrease in sy...

It is often challenging to assess cardiac filling pressure clinically. An improved system for detecting or ruling out elevated cardiac filling pressure may help reduce hospitalizations for heart failure. The blood pressure response to the Valsalva maneuver reflects left heart filling pressure, but its underuse clinically may be due in part to lack of continuous blood pressure recording along wi...

The Valsalva maneuver was performed during cardiac catheterization in 9 patients who had undergone a Fontan operation (Fontan group) and in 10 control subjects. The Fontan group had higher right atrial (RA) pressure (16 f 1 vs 4 f 0.5 mm Hg, p <O.OOi), lower cardiac index (2.5 f 0.1 vs 3.7 f 0.2 liters/min/m*, p <0.05), lower stroke index (32 f 2 vs 44 f 2 ml/beat/m*, p <0.05), and higher syste...

This study evaluated the efficacy of the valsalva maneuver that can induce baroreceptor activation and nociception, on needle projection pain and hemodynamic responses associated with spinal puncture. Ninety adults, ASA physical status I and II undergoing elective surgeries were included. Patients were randomized into three equal groups. Group I (C): control; Group II (B): ball; pressed a rubbe...