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At least 19 recordsLinked to original sources
PubMed1992

[Aggravation of hypoxemia in supine position in myotonic dystrophy].

Myotonic dystrophy (MyD) involves a variety of systems. Respiratory disorders are common, namely elevation of diaphragm, alveolar hypoventilation, aspiration pneumonia and sleep apnea. We evaluated respiratory involvement. The subjects were 11 patients with MyD. Also 6 patients with limb girdle muscular dystrophy (LG) were examined to be compared with MyD. Both groups had the similar activities of daily living. All of them never complained of dyspnea. Arterial blood gas studies were performed in supine position and standing position. A new evidence was found that hypoxemia was aggravated and alveolar-arterial oxygen pressure difference was increased in supine position in MyD. Next, pulmonary function tests were done in supine position and sitting position. Functional residual capacity (FRC) were more reduced in supine position in MyD compared with LG. The value to subtract closing capacity from FRC was negative in supine position in MyD, showing closing phenomenon. We propose the mechanism of the aggravation of hypoxemia may be the following. The reduction of FRC caused by respiratory muscle involvement brings out the closing phenomenon. Abnormal uneven distribution of ventilation-perfusion ratio happens and then hypoxemia is worsened in supine position in MyD.

Adult↗
PubMed1979

The effect on dosimetry of changing from the lithotomy to the supine position in treating uterine cancer with the Cathetron and external radiotherapy.

Uterine carcinoma can be treated by combined external and intracavitary irradiation. With an afterloading technique intracavitary irradiation is given with the patients in the lithotomy position. External irradiation is given with the patient in the supine position. A lead shield is used with the external fields to cover the tissues which are close to the intracavitary sources and receive high doses. The positions of the intracavitary sources seen on radiographs taken when the patient is in the lithotomy position are transferred to films taken with the patient in the supine position. From the latter the position and profile of the shield are calculated. It is shown that a reliable transfer of the positions of the sources and determination of the necessary shielding cannot be achieved in this way. It is therefore concluded that both intracavitary and external irradiation should be carried out with the patient in the supine position.

Cobalt Radioisotopes↗
PubMed1992

[Unexpected air embolism during an aneurysmal operation in supine position--a case report and a speculation about its pathogenesis].

The occurrence of air embolism in supine position operation is extremely rare. We reported a case of air embolism during the operation of a ruptured middle cerebral artery aneurysm in supine position. A 58-year-old woman was admitted to our hospital in semicomatous state. A CT scan revealed diffuse subarachnoid hemorrhage. Cerebral angiogram showed a middle cerebral artery aneurysm. Massive pinkish foamy sputum and butterfly shadow on chest x-ray strongly suggested an association of neurogenic pulmonary edema (NPE). Barbiturate therapy and controlled ventilation with positive end-expiratory pressure (5cmH2O) were started. Her airway pressure was about 35cmH2O. Decrease of pinkish foamy sputum and an improvement of chest x-ray findings on the next day encouraged us to perform a clipping operation. Just before a clip application, air bubbles were observed to pass through the middle cerebral artery under the microscope. Subsequently cardiac standstill was brought out. Fortunately, she was resuscitated, and a clip application was finished. A postoperative CT scan revealed an infarction in the middle cerebral artery area. A postoperative cerebral angiogram showed occlusion of a temporal branch of the right middle cerebral artery, P1 portion of the left posterior cerebral artery, and the right superior cerebellar artery. We speculated that high endotracheal pressure brought out pulmonary alveolar rupture, and in spite of supine position operation massive air, which flowed into systemic circulation from ruptured alveoli, caused cerebral infarction and cardiac arrest. We consider that unrecognized air embolism might be the one of the factors influencing the prognosis of severe subarachnoid hemorrhage, especially in the cases associated with neurogenic pulmonary edema.

Embolism, Air↗
PubMed1978

Inclined or conventional supine position in ultrasonic examinations in late pregnancy.

Ultrasonic examinations were made on 22 patients in late pregnancy both in the conventional supine position and in an inclined position. The findings give rise to the following conclusions: 1) The inclined position prevents the development of the vena cava inferior syndrome. 2) The examinations can be made as easily and accurately in the inclined as in the conventional supine position. 3) In cases where the head is in the occipito-posterior position the inclined position may increase the reliability of the measurement of the biparietal diamter. The authors consider it recommendable to use the inclined position instead of the conventional supine position in ultrasonic examinations to maintain both maternal and fetal well-being during the procedure.

Female↗
PubMed1977

Cervical traction. A comparison of sitting and supine positions.

Eight students were studied todetermine the position which provided the greatest amount of posterior intervertebral separation during a cervical traction treatment. A standard angle of 45 degrees with traction apparatus set at zero, 14 Kg (30 pounds), and 18 Kg (40 pounds) were used in both sitting and supine positions. Measurements of posterior intervertebral separation taken from lateral roentgenograms of the C4-C7 vertebrae revealed greater separation in the supine positions. The results suggested that the supine position was more beneficial in treatment of the cervical spine with traction. The investigators concluded that the increased separation in the supine position was related to the patient's increased comfort and relaxation.

Adult↗
PubMed1991

Effect of left-lateral position on maternal hemodynamics during ritodrine treatment in comparison with supine position.

Pregnant women are generally recommended to rest in the left-lateral position (l-lat.) to avoid caval compression. We studied the influence of postural change from the supine position (sup.) to the l-lat. on maternal hemodynamics and tocolysis. The cardiac output (CO) was measured by impedance cardiography, while the pulsatility index of the uterine artery (PIUtA) was determined by the pulsed Doppler method. When the maternal posture was changed from sup. to l-lat, the following results were obtained. (1) The frequency of uterine contractions (UC) (preterm labor = 92) was significantly reduced (p less than 0.01). (2) The resting uterine tonus (n = 5) was also significantly decreased (p less than 0.05). (3) In the cases showing a decrease in the frequency of UC, the CO value was significantly increased (p less than 0.01), whereas PIUtA was significantly decreased (p less than 0.01). It is concluded that the postural change from sup. to l-lat. resulted in a decrease in the frequency of UC and the resting uterine tonus and at the same time an increase in the CO and decrease in the vascular resistance of the uterine artery.

Cardiac Output↗
PubMed1992

Why deliver in the supine position?

This study was conducted at the Lokmanya Tilak Municipal General Hospital, Bombay, India during the year 1990. The aim was to compare the routinely used supine position versus ambulation in the first stage and squatting position during the second stage of labour. Our study was comprised of 200 patients both primigravidas and multigravidas; 100 were kept in the supine position throughout labour and 100 were kept ambulatory in the first stage and adopted the squatting position during the second stage. The study showed a shortening of both stages of labour in the squatting group but the incidence of complications was less in the control group. It was concluded that without proper birthing chairs which can give excellent perineal support, the usual supine position is preferable in our setup.

Adult↗
PubMed1977

Argon laser treatment in supine position.

When using an argon laser photocoagulator it is often advantageous and sometimes indispensable to treat the patient in a supine position. Stabilization of the laser beam requires the use of a microscope equipped with a beam manipulator (joystick) that maintains the orientation of the laser beam wherever it is placed, without the operator having to hold the joystick. A low-vacuum contact lens or a three-mirror lens, and a microscope suspended from a floor stand are used. The patient is placed in the supine position on a stretcher of adjustable height with his head in a foam rubber conformer. Local anesthesia may not be necessary, but if indicated, the patient should not be treated in an upright position. A lid block is rarely required. General anesthesia is used with patients who cannot cooperate. There are 4 main indications for treatment in the supine position: (1) cases in which great accuracy is needed, such as treatment near the macula; (2) all cases in which retrobulbar anesthesia is necessary, with or without a lid block; (3) cases in which the patient is unable to cooperate; and (4) cases that require prolonged photocoagulation.

Adult↗
PubMed1992

Gas exchange in dogs in the prone and supine positions.

To determine the cause of the difference in gas exchange between the prone and supine postures in dogs, gas exchange was assessed by the multiple inert gas elimination technique (MIGET) and distribution of pulmonary blood flow was determined using radioactively labeled microspheres in seven anesthetized paralyzed dogs. Each animal was studied in the prone and supine positions in random order while tidal volume and respiratory frequency were kept constant with mechanical ventilation. Mean arterial PO2 was significantly lower (P less than 0.01) in the supine [96 +/- 10 (SD) Torr] than in the prone (107 +/- 6 Torr) position, whereas arterial PCO2 was constant (38 Torr). The distribution of blood flow (Q) vs. ventilation-to-perfusion ratio obtained from MIGET was significantly wider (P less than 0.01) in the supine [ln SD(Q) = 0.75 +/- 0.26] than in the prone position [ln SD (Q) = 0.34 +/- 0.05]. Right-to-left pulmonary shunting was not significantly altered. The distribution of microspheres was more heterogeneous in the supine than in the prone position. The larger heterogeneity was due in part to dorsal-to-ventral gradients in Q in the supine position that were not present in the prone position (P less than 0.01). The decreased efficiency of oxygenation in the supine posture is caused by an increased ventilation-to-perfusion mismatch that accompanies an increase in the heterogeneity of Q distribution.

Animals↗
PubMed1991

Leg movements in the supine position of infants with spastic diplegia.

Leg movements in the supine position of 49 infants with spastic diplegia (three to 11 months corrected age) were examined. Only simultaneous flexion and extension of the hips and knees were seen, with exceptional isolated hip movements; the simultaneous movements had synergic features. When the knees were flexed, the hips were flexed, abducted and externally rotated, and the ankles were dorsiflexed. When the knees were extended, the hips were extended, adducted and internally rotated and the ankles were plantar-flexed. Hip flexion combined with knee extension (leg elevation) and isolated knee movements were not seen in diplegic infants, but were seen in all control preterm infants with a good prognosis, after five and six months corrected age, respectively. The absence of these movements is a useful diagnostic item for spastic diplegia.

Cerebral Palsy↗
PubMed1992

Preoxygenation of pregnant and nonpregnant women in the head-up versus supine position.

The influence of preoxygenation in the supine (n = 10) versus the 45 degrees head-up (n = 10) position on the duration of apnea leading to a decrease in arterial oxygen saturation to 95%, as monitored by pulse oximetry, was investigated in 20 women undergoing elective cesarean section at term of pregnancy. The results were compared with those obtained in a control group of 20 nonpregnant women. In the supine position, the average time to desaturation to 95% was significantly shorter in the pregnant group (173 +/- 4.8 s [mean +/- SD]) than in the control group of nonpregnant women (243 +/- 7.4 s). Using the head-up position resulted in an increase in the desaturation time in the nonpregnant group (331 +/- 7.2 s) but had no significant effect in the pregnant group (156 +/- 2.8 s). We conclude that pregnant women desaturate their arterial blood of oxygen more rapidly than do nonpregnant women. Furthermore, the head-up position extends the duration of apnea that can take place before desaturation occurs in nonpregnant patients.

Adult↗
PubMed1979

Plasma volume and electrolyte shifts with heavy exercise in sitting and supine positions.

Plasma volume (PV) and electrolyte shifts were measured before and for 60 min after a continuous peak oxygen uptake (VO2 peak) test in four men (26-45 yr) on a bicycle ergometer. Mean (+/-SE) sitting VO2peak (3.16 +/- 0.32 1/min) was the same as supine VO2peak (3.13 +/- 0.33 1/min). In recovery (R + 1.5 min), mean PV had decreased by 477 ml (-16.1%, P less than 0.05) in the sitting and by 548 ml (-17.6%, P less than 0.05) in the supine positions, whereas total osmolality increased progressively with its peak at R + 3.5 min. The percentage losses of protein, total Ca2+, and ionized Cai2+ were about half as great as the percentage loss in PV, indicating a selective retention of these constituents. Calculated osmolality (sigma Na+, K+, Cl-, Cai2+) returned to control levels within 1.5 min after sitting exercise but required about 15 min after supine exercise. These small increases in protein concentration were not likely to significantly aid restitution of plasma volume and the ions were probably in equilibrium across the capillary membrane. So a change in hydrostatic and/or systemic blood pressures most likely provided the force for restitution of plasma volume.

Adult↗
PubMed1990

[Syncope caused by paroxysmal atrial fibrillation and flutter: diagnostic usefulness of electrophysiological studies in the erect and supine positions].

In this study, we verified if the induction of atrial fibrillation/flutter, during the electrophysiological study, could be useful for the evaluation of syncope of unknown origin. Of 292 patients who underwent an electrophysiological study for unexplained symptoms, we selected 15 patients (5.1%) affected by syncope and pre-syncope. In these, the induction of atrial fibrillation (14 patients) or flutter (1 patient) just at the onset caused, the reproduction of the spontaneous symptoms. No other cause could be identified. These patients were affected by: 1) syncope or pre-syncope without electrocardiographic documentation of paroxysmal atrial fibrillation/flutter 2) syncope or presyncope and documented asymptomatic episodes of paroxysmal atrial fibrillation/flutter. Palpitations closely preceded or followed the syncope in 11/15 patients. Symptom reproduction was obtained in the supine position in 3 patients (heart rate 180 +/- 82 beat/min, systolic blood pressure 53 +/- 6 mmHg) and in the upright position in 12 patients (heart rate 177 +/- 24, systolic blood pressure 65 +/- 18 mmHg). The arrhythmia was induced by incremental atrial pacing or premature atrial beats in 3 cases, ramp in 3 cases and burst--mean rate 339 +/- 48 beat/min--in 9 cases. The arrhythmia lasted for a period of time ranging from a minimum of 1 mm to a maximum of 24 hours (median 1 hour). During sinus rhythm, an abnormal vasodepressor reflex (with a systolic blood pressure fall greater than or equal to 50 mmHg) could be induced in 7/9 patients by carotid sinus massage or 60 degrees tilt test.(ABSTRACT TRUNCATED AT 250 WORDS)

Atrial Fibrillation↗
PubMed1992

[Continuously alternating prone and supine positioning in acute lung failure].

Acute respiratory failure is still one the main problems in surgical intensive care. Unknown pathophysiological mechanisms permit only symptomatic therapy. Today ventilatory strategies by using PEEP und IRV are established to improve gas exchange and FRC by recruiting collapsed alveoli, decreasing intrapulmonary shunting and returning V/Q matching to normal. Furthermore different studies have shown the effects of supine and lateral decubitus posture in patients with acute respiratory failure. There are only rare reports on using the prone position, which doesn't require two-lung ventilation in difference to lateral position. We have studied 16 patients with acute respiratory failure by using continuous changing between prone and supine position under mechanical ventilation. All were male, aged 41.3 years in the middle and showed an average "Injury Severity Score" of 30 (13-50). 15 were trauma patients with blunt chest trauma in 11 cases. We have used prone position on threatening or manifest ARDS. In all patients we observed an increment of PaO2 during prone position on to 48 mmHg so that FiO2 could be reduced on an average of 0.2 within the first 48 h since changing patient's position. Posture changing depends on blood gas analysis, specifically on decreasing PaO2 after previous increment. Patients remained in prone and supine position at a mean of 6.3 (4.5-20) h and posture changing was proceeded over a period of 15.4 (7-32) days. No problems recording to blood pressure or mechanical ventilation appeared during prone position. 11 of 16 patients survived (68.8%), 5 died of cardiac (2) and multi organic failure (3) in connection with sepsis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Effects of prone and supine position on heart rate, respiratory rate and motor activity in fullterm newborn infants.

Polygraphic recordings were obtained for 24 normal full-term neonates on their 4th or 5th day of life. Thirteen of the infants were first fed, laid supine for 3 hours, fed again around noon and laid prone for 3 more hours. The other 11 were first laid prone and then supine. The awake state was observed more in the supine than the prone position (P less than 0.001). Wakefulness occurred at the expense of state 1 and/or state 2. The heart rate (HR) was higher in babies lying prone. It was also higher in the afternoon than in the morning. No such relationship was found for the respiratory rate (RR). There was higher average EMG activity during state 1 in the prone position. The cross-correlation between HR and EMG activity was positive during state 2, and states 4 and 5, regardless of the position. The cross-correlation between the RR and the EMG was usually negative in state 2, and in states 4 and 5, there being many exceptions. The cross-correlation between breathing and heart-beat was mostly negative during state 2, but it eventually became positive due to periodic breathing, central apnoeas with bradycardia, stretches, and crawling movements.

Electrocardiography↗
PubMed1992

Differences in developmental movement patterns used by active versus sedentary middle-aged adults coming from a supine position to erect stance.

The purpose of this study was twofold: (1) to further validate categories for the movement pattern of supine to standing in adults and (2) to evaluate the influence physical activity might have on the movement patterns used for rising. Seventy-two adults, between 30 and 39 years of age (mean = 34.1, SD = 2.8), performed the rising task while being videotaped. Subjects were divided into three groups by self-reports of level of physical activity (daily to rarely). Individual videotaped trials were classified using the previously described categories. Comparisons among the activity-level groups revealed that more active subjects demonstrated more developmentally advanced movement patterns in the righting task, consistent with earlier research on older adults. Results suggest that lifestyle patterns of regular, moderate physical activity may influence how a person performs the basic righting task of coming from a supine to a standing position. This investigation also provided additional support for the use of developmental sequences for the movement pattern of supine to standing.

Adolescent↗