Am J Surg. 1987 Aug;154(2):220-4.
Anatomic and pathophysiologic studies of the human internal jugular valve.
Dresser LP, McKinney WM.
The results of anatomic and hemodynamic studies of the human internal jugular valve, which is the only venous valve between the right atrium of the heart and the brain, have been reported. Tricuspid internal jugular valves were present in two cadaver subjects without any observed compromise in competency. Most valves tested were competent, with the exception of those from one cadaver which were apparently congenitally incompetent. Acquired or congenital internal jugular valve incompetence may impair cerebral venous return, especially when intrathoracic pressure is increased by positive-pressure ventilation. Screening for internal jugular valve incompetence with a Doppler flowmeter before utilizing this type of mechanical ventilation may help prevent the deleterious effects of cerebral venous congestion.
Two thoughts here:
1) one cadaver had bilateral IJV valve congenital incompetence - could that mean congenitally malformed valves as seen in CCSVI? This was in 1987. It is good to see historical data noticing IJV valve malformations even before they were implicated as CCSVI.
2) If we have had the CCSVI procedure, and if we had valvular stenoses ballooned, the treatment is successful if the valves are obliterated. But if the valves are obliterated, we now have IJV valve incompetence, meaning there are no valves to block flow from refluxing from the heart. In this condition, mechanical positive-pressure ventilation can lead to cerebral venous congestion.
What is nonvinvasive positive pressure ventilation?
What is noninvasive positive pressure ventilation?
With NIPPV, the patient wears a tightly fitting nasal or full facial mask, avoiding the need for an endotracheal tube, laryngeal mask, or tracheostomy (Figure 1).2 The mask can be connected to a standard mechanical ventilator or, more commonly, to a continuous positive airway pressure or bi-level airway pressure unit. NIPPV has been used with variable success in a variety of conditions, including COPD exacerbations,3–6 acute cardiogenic pulmonary edema,7 hypoxemic respiratory failure,8 and ventilator weaning.9
https://www.clevelandclinicmeded.com/me ... rshman.htm
That would include a CPAP machine, wouldn't it?
CPAP performs a needed function for those with sleep apnea. But after a CCSVI procedure, if the jugular valves are treated, the pressure created by the CPAP might contribute to further cerebral venous congestion. If possible, the best case scenario might be to lose weight or treat the throat surgically as alternatives to CPAP. Losing weight might be enough to reduce the amount of pressure needed.
These are all thoughts based on my understanding of the research and not intended as medical advice! I am no doctor. But I am going to do my best to avoid COPD, respiratory failure, or anything that might land me on a ventilator...
it also notable that CPR may no longer work on us either! so I am also going to avoid heart attacking. For me the benefits of having my jugular valvular stenoses treated has outweighed these possible concerns.
These findings may have important implications concerning the failure, in some cases, of closed-chest cardiac resuscitation to maintain forward blood flow at adequate pressure.