Modelling of Venous Biomechanics and Evaluation using Imaging, Positive Airway Pressure and Postural Changes
Abstract: Knowledge about biomechanical properties of veins is of importance for understanding the physiologyof the venous system. Specifically for this thesis there is a motivation based on an idea of how to usebiomechanics of the vein in the development of new non-invasive measurement techniques for assessingthe pressure in the brain. The cross sectional area of veins is known to depend on pressure changes insidethe vessel. There are many ways of provoking these pressure changes, like changing posture or creating apositive airway pressure. The hypothesis is that the positive airway pressure will increase the intrathoracic pressure and in turnincrease the pressure in the internal jugular veins by the same magnitude. The cross sectional area will from a pressure change subsequently change with respect to the biomechanical properties of the vessel walls. A first aim in this study was to determine how the cross sectional area of the internal jugular veins is altered due to changes in airway pressure. A second aim was to develop and evaluate a model where the biomechanical properties of the internal jugular veins is described, based on the relationship between pressure and area of the vein. Ultrasound measurements were performed on one healthy adult man to study the effect on the cross sectional area at different pressure provocations. Measurements on the subject was performed at four different head up tilt angles, causing a pressure decrease in the internal jugular vein. A controlled Valsalva method was performed to give the positive airway pressure giving corresponding pressure increases. With an increased airway pressure the effect on cross sectional area changes was about 23% of the effect dueto hydrostatic pressure changes, at a tilt angle from 0° to 8°. At a tilt angle from 8° to 16° the effect was about 35%. Thus the venous pressure seems to be increased due to an increased airway pressure, but not tothe same magnitude. The theoretical model was developed and subsequently evaluated using existing head down tilt magneticresonance imaging data on nine healthy volunteers. An expression for how radius of the vessel depends on pressure changes was derived and evaluated. This expression included individual biomechanical properties that were estimated on group level for the nine subjects. The resulting equation could beused to give an approximate prediction of the increase in radius to a change in venous pressure. In conclusion, the hypothesis suggesting that a positive airway pressure would give an equally increased venous pressure could not be confirmed, and this knowledge should be considered when trying to assess thepressure in the brain with this technique. The derived biomechanical model was promising for predictionof cross sectional area with respect to a change in venous pressure.
AT THIS PAGE YOU CAN DOWNLOAD THE WHOLE ESSAY. (follow the link to the next page)