静脈圧に対する一考察 : 上腕緊縛時の肘静脈圧

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As factors controlling the venous pressure one can reckon the heart function, the tonicity of the venous wall, the amount of blood in circulation, respiration, the force of gravity and others. Whereas viewing solely from the stand point of the heart function, the venous pressure may be interpreted as representation of the balance between the efferent pressure of the left ventricle through the venous capillary system and the suction power of the right ventricle though the latter is not so marked. We have previously reported that physiologically there is a falling tendency in the venous pressure along with the advance of age despite a rising tendency in the arterial blood pressure. We have then deduced that a cause for this fact lies in the resistance to the blood flow due to the physiological sclerosis of arterioles. On the assumption that the resistance to the blood flow in the capillary system including arterioles may be ascertained if the arterial blood pressure and the cubital venous pressure are compared after eliminating the influence of the right ventricle by throwing various pressures on the upper arm, I have carried out such measurements and obtained some interesting results.Method The arterial blood pressure is measured after having the subject lie down in the recumbent position for 10 minutes. Next, with the use of a water level (the type designed by ourselves) and following Moritz and Tabora's technique, the puncture point is adjusted at 5 cm below the joint where the fourth rib is attached to the sternum. At this moment the elbow is slightly extended and is kept approximately at 45 degree angle with the axis of the body and the elbow is supported by either a pillow or folded towel. As a rule the puncture is made on V. med. cubiti but sometimes V. cephalica or V. basilica is selected depending upon the size and the direction of the vein. Using a spinal fluid puncturer, the glass-tube for measuring the blood pressure is filled with citrate to the height of about 10cm and a syringe is connected to the mandrin inlet and about 2cc citrate is kept in the mandrin. When the vein is punctured, the three-way stopcock is so turned as to connect the glass-tube with the puncture needle, and the lowest level of the fluid is taken as the venous pressure. Then, keeping the needle in the vein, a cuff is wounded around the upper arm and, at first, the pressure of 80 mmHg (at discretion) is thrown in. Thus the level of the fluid in the glass-tube rises and is stabilized. This level of the fluid is the venous pressure at the time when the pressure of 80 mmHg is thrown on the upper arm. It is necessary to avoid the blood from coagulation by injecting small amount of citrate from time to time by adjusting small amount of citrate from time to time by adjusting the three way stopcock. Next, when the pressure above the maximum blood pressure is thrown in the cuff and then it is gradually lowered, the elevated level of the fluid will fall. However. when the pressure reaches a certain point, the column of the fluid stops falling and begins to rise rapidly. When this pressure is sustained for a little while, the level rises and becomes stabilized. This level is the maximum venous pressure, and the pressure thrown in the cuff is the strain pressure at that moment. Result Nine young persons selected were all female except one, and 11 elder persons were all male. The average age of the former was 22.9 years while that of the latter 54.6 years. The specific gravity of blood is 1050-1060,but in computing mmH_2O into mmHg, the specific gravity of mmH_2O is set at 1,000. Moreover, the surface tension effect of the glass-tube was not eliminated. 1. The average arterial blood pressure of young persons is 119-63 mmHg and that of the venous pressure 101 mmH_2O. The average arterial pressure of elder persons is 130-81 mmHg and the venous pressure 60 mmH_2O. As already reported previously, even in this instance the arterial pressure (the blood pressure) o
社団法人日本循環器学会の論文
1960-06-20

静脈圧に対する一考察 : 上腕緊縛時の肘静脈圧

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