THE INFLUENCE OF RESPIRATION ON VENOUS PRESSURE

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Abstract
Venous pressure determinations were made by the indirect method, using veins of the upper extremity. Bronchial asthma per se in the interval between attacks induced no elevation of the venous pressure (11 cases). During asthmatic seizure the venous pressure rose precipitously, as in one case, from 11 to 23 cm. of water, maintaining a high level during the attack. With Cheyne-Stokes respiration the venous pressure invariably increased (18 cases) during the apneic phase and fell with hyperpnea regardless of the basic level. The average difference was 6 cm. of water. Under the conditions of the Valsalva and Muller experiments in normal individuals the venous pressure increased steadily during the period of effort, usually reaching a level between 20 and 40 cm. of water for the former and a somewhat lower level for the latter. The greatest increase occurred during the first 3 secs. of effort in both tests. The Valsalva experiment, on selected completely compensated cardiac patients, resulted in a rise of venous pressure simulating that of the normal controls. In decompensated cases the response was inadequate and less precipitous, and the effort was maintained for a shorter period. The venous pressure responses to the Valsalva test as a measure of right heart efficiency may give some prognostic information in the borderline case, or some idea of the return of myocardial efficiency; but the test must have a very limited field of usefulness because of the serious risk involved in cardiac patients.

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