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      Lower Limb Compression Bandaging Is Effective in Preventing Signs and Symptoms of Seating-Induced Postural Hypotension

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          Abstract

          Background and Aims: Data concerning postural hypotension (PH) induced by transition from supine to sitting position are scarce and measures for its prevention have not been investigated. Our objective was to assess the preventive role of lower limb compression bandaging on PH and associated manifestations in older inpatients when seated from lying position. Methods: In a randomized crossover study, 61 patients aged >65 years were enrolled. Following bed rest lasting >36 h, each patient was seated and studied for 2 consecutive days, unbandaged or bandaged. PH was defined as a fall of ≧20 mm Hg and/or ≧10 mm Hg in systolic/diastolic blood pressure, respectively. Compression bandages were applied along both legs before seating; the pressure was approximately 30 mm Hg. Blood pressure, heart rate, O<sub>2</sub> saturation, dizziness and palpitations were recorded prior to and 1, 3, and 5 min following seating. Results: Prevalence of PH was identical in the unbandaged versus bandaged state (55.7%). However, dizziness, palpitations, accelerated heart rate and decreased O<sub>2</sub> saturation over 5 min were more prevalent in the unbandaged versus bandaged state (p < 0.01, <0.001, <0.05, <0.001, respectively). In the unbandaged state, presence versus absence of PH was associated with significantly greater incidence of palpitations, tachycardia and decline of O<sub>2</sub> saturation over time (p < 0.04, <0.03, <0.03, respectively). In the bandaged state, O<sub>2</sub> saturation over 5 min tended to rise irrespective of PH, but mean values were higher in patients without PH (p < 0.02). Conclusions: Lower limb compression bandaging does not reduce the incidence of PH. However, associated manifestations are largely prevented.

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          Most cited references 6

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          Orthostatic hypotension in the elderly.

           L. Lipsitz (1989)
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            Sustained compression and healing of chronic venous ulcers.

            Comparison of four layer bandage system with traditional adhesive plaster bandaging in terms of (a) compression achieved and (b) healing of venous ulcers. Part of larger randomised trial of five different dressings. Outpatient venous ulcer clinic in university hospital. (a) Pressure exerted by both bandage systems was measured in the same 20 patients. (b) Healing with the four layer bandage was assessed in 148 legs in 126 consecutive patients (mean age 71 (SE 2); range 30-96) with chronic venous ulcers that had resisted treatment with traditional bandaging for a mean of 27.2 (SE 8) months. (a) Four layer bandage system or traditional adhesive plaster bandaging for pressure studies; (b) four layer bandaging applied weekly for studies of healing. (a) Comparison of pressures achieved at the ankle for up to one week; (b) complete healing within 12 weeks. (a) Four layer bandage produced higher initial pressures at the ankle of 42.5 (SE 1) mm Hg compared with 29.8 (1.8) for the adhesive plaster (p less than 0.001; 95% confidence interval 18.5 to 6.9). Pressure was maintained for one week with the four layer bandage but fell to 10.4 (3.5) mm Hg at 24 hours with adhesive plaster bandaging. (b) After weekly bandaging with the four layer bandage 110 of 48 venous ulcers had healed completely within 12 (mean 6.3 (0.4)) weeks. Sustained compression of over 40 mm Hg achieved with a multilayer bandage results in rapid healing of chronic venous ulcers that have failed to heal in many months of compression at lower pressures with more conventional bandages.
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              Prevalence of postural hypotension in elderly patients in a long-term health care facility

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                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                2004
                October 2004
                15 October 2004
                : 102
                : 4
                : 177-183
                Affiliations
                Departments of aInternal Medicine ‘F’ and bNephrology, Assaf Harofeh Medical Center, (affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv), Zerifin, Israel
                Article
                81007 Cardiology 2004;102:177–183
                10.1159/000081007
                15452389
                © 2004 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 6, Tables: 1, References: 16, Pages: 7
                Categories
                General Cardiology

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