2026-04-14T02:28:54Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/122752024-11-29T08:30:56Zcom_2072_378071com_2072_378040col_2072_378097

00925njm 22002777a 4500 dc de Lange, Frederik author de Jong, Jelle author van Zanten, Steven author Hofland, Willem Petrus Merijn Emmanuël author Tabak, Rick author Cammenga, Marianne author Francisco Pascual, Jaume author 2024-11-26T09:17:16Z 2024-11-26T09:17:16Z 2024-10-14 Carotid sinus massage; Haemodynamic monitoring; Syncope Masaje del seno carotídeo; Monitorización hemodinámica; Síncope Massatge del sinus carotidi; Monitorització hemodinàmica; Síncope Carotid sinus massage (CSM) as integral part of cardiovascular autonomic testing is indicated in all patients > 40 years with syncope of unknown origin and suspected reflex mechanism. However, large practice variation exists in performing CSM that inevitably affects the positivity rate of the test and may result in an inaccurate diagnosis in patients with unexplained syncope. Even though CSM was introduced into medical practice more than 100 years ago, the method of performing CSM is still largely operator- and centre-dependent, while in many places, the test has been entirely abandoned. Here, we describe a standardized protocol on how to perform CSM, which basic monitoring equipment is necessary and why CSM is a safe procedure to perform. Our aim is to create a uniform approach to perform CSM. The new proposed algorithm, the Six-Step-Method, includes: (i) check history for exclusion CSM; (ii) turn head slightly contralaterally and posterior (see also explanatory video and poster provided as Supplementary material; (iii) palpation to identify carotid sinus location; (iv) massage for 10 s; (v) monitoring of blood pressure and heart rate to assess of the haemodynamic response type; and (vi) include time intervals between subsequent massages. Carotid sinus massage should be performed on both the left and right and in the supine and upright position. The recommended equipment to perform CSM consists of: (i) a tilt table in order to perform CSM in supine and standing position, (ii) a continuous blood pressure monitor or cardiac monitor, and (iii) at least two persons. Hemodinàmica Síncope (Patologia) Si carotidi Massatge cardíac ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Emergency Treatment::Resuscitation::Heart Massage DISEASES::Nervous System Diseases::Neurologic Manifestations::Neurobehavioral Manifestations::Consciousness Disorders::Unconsciousness::Syncope Other subheadings::Other subheadings::/diagnosis ANATOMY::Cardiovascular System::Blood Vessels::Arteries::Carotid Arteries::Carotid Sinus PHENOMENA AND PROCESSES::Circulatory and Respiratory Physiological Phenomena::Cardiovascular Physiological Phenomena::Hemodynamics TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::tratamiento de urgencia::resucitación::masaje cardíaco ENFERMEDADES::enfermedades del sistema nervioso::manifestaciones neurológicas::manifestaciones neuroconductuales::trastornos de la conciencia::inconsciencia::síncope Otros calificadores::Otros calificadores::/diagnóstico ANATOMÍA::sistema cardiovascular::vasos sanguíneos::arterias::arterias carótidas::seno carotídeo FENÓMENOS Y PROCESOS::fenómenos fisiológicos respiratorios y circulatorios::fenómenos fisiológicos cardiovasculares::hemodinámica Carotid sinus massage in clinical practice: the Six-Step-Method