What is pulmonary vascular resistance index. How is PVRI calculated. Why are correct units crucial for PVRI. What are the implications of incorrect PVRI reporting. How does PVRI impact clinical decision-making.

Defining Pulmonary Vascular Resistance and Its Index

Pulmonary vascular resistance (PVR) is a critical measure in cardiopulmonary medicine, quantifying the resistance blood encounters as it flows through the pulmonary vasculature. The Pulmonary Vascular Resistance Index (PVRI) takes this concept a step further by relating PVR to a patient’s body surface area, thus accounting for variations in body size that can affect blood flow.

How is PVR calculated? The most practical formula for determining PVR is based on the hydraulic equivalent of Ohm’s law:

PVR = (pressure gradient) / (pulmonary blood flow)

This equation can be further expressed as:

PVR = (mmHg * min) / L = Wood units (WU) = 80 * dynes * sec * cm^-5

In this formula, the pressure gradient is calculated by subtracting the mean pulmonary artery wedge pressure (PAWP) from the mean pulmonary artery pressure (mPAP).

The Importance of Accurate Measurements in PVRI Calculation

Accurate measurement of mPAP and PAWP is crucial for obtaining valid PVR results. There is ongoing debate regarding the optimal timing of PAWP measurement within the respiratory cycle. While current consensus documents recommend end-expiration measurements, some researchers argue that this may not represent the most physiological approach due to variations across respiratory phases impacting pressure and resistance.

In cases where PAWP cannot be obtained, such as in the presence of a pulmonary artery aneurysm, mean left atrial pressure (LAP) may be used as a substitute. Left ventricular end-diastolic pressure (LVEDP) can also serve as a surrogate, though it typically yields values 2-3 mmHg higher than PAWP.

Measuring Pulmonary Blood Flow: Thermodilution vs. Fick Method

Pulmonary blood flow (Qp) is another critical component in PVR calculation. In the absence of intracardiac shunting, Qp can be accurately measured using the thermodilution method. However, this method may be confounded by right-to-left shunts or tricuspid regurgitation.

When is the Fick method preferred for determining Qp? In cases where thermodilution may be unreliable, the Fick method can be employed:

Qp = oxygen consumption / (pulmonary vein oxygen content – pulmonary artery oxygen content)

It’s important to note that recent studies have questioned the interchangeability of thermodilution and Fick methods for cardiac output determination. The accuracy of the Fick method heavily depends on proper assessment of oxygen consumption (VO2), which can be directly measured or derived using empirical formulae.

The Significance of Oxygen Consumption Measurement

While both measured and estimated VO2 are commonly used in clinical practice, most experts agree that measured VO2 is superior for calculating pulmonary blood flow. A study by Chase et al. found significant discrepancies between measured and estimated VO2 in patients with heart failure and reduced ejection fraction.

How is oxygen content determined for PVR calculation? The following formula is used:

Oxygen content = (Hb g/dL * 10 dL/L * 1.36 mL/g * % saturation) / 100

This calculation is performed for both pulmonary venous and arterial blood, with the difference used in the Fick equation to determine Qp.

PVRI: Adjusting PVR for Body Surface Area

PVRI is calculated by indexing PVR to the patient’s body surface area (BSA). This adjustment allows for more accurate comparisons between individuals of different sizes and is particularly useful in pediatric populations.

The formula for PVRI is:

PVRI = PVR * BSA

Where BSA is typically measured in m^2, resulting in PVRI units of Wood units * m^2 or dynes * sec * cm^-5 * m^2.

The Confusion Surrounding PVRI Units in Medical Literature

A comprehensive literature review revealed significant variability in the units used to report PVRI. Out of 218 sources with defined PVRI units, 33 unique variants were identified. Alarmingly, only 45.4% of sources reported PVRI with units correctly ending in m^2, while 54.6% used incorrect units not ending in m^2.

This lack of uniformity in reporting PVRI has led to considerable confusion among researchers and clinicians. Why is this problematic? Inconsistent or incorrect units can lead to misinterpretation of data, potentially resulting in inappropriate clinical decisions with serious consequences for patient care.

Clinical Applications and Implications of PVRI

PVRI plays a crucial role in various clinical scenarios, including:

• Predicting outcomes in heart and liver transplantation
• Determining candidacy for closure of atrial or ventricular septal defects
• Guiding treatment of pulmonary hypertension

How does PVRI impact clinical decision-making? In the context of organ transplantation, elevated PVRI can indicate increased risk of right ventricular failure post-transplant. For congenital heart defects, PVRI helps determine whether surgical closure of septal defects is feasible without causing pulmonary hypertension. In pulmonary hypertension management, PVRI guides treatment strategies and helps monitor disease progression.

The Consequences of Incorrect PVRI Reporting

Misreporting or misinterpreting PVRI can have serious clinical implications. For example, underestimating PVRI due to incorrect units could lead to inappropriate surgical interventions in patients with congenital heart defects, potentially resulting in life-threatening complications. Conversely, overestimating PVRI might unnecessarily exclude patients from potentially beneficial treatments or interventions.

What steps can be taken to address this issue? Standardization of PVRI reporting is crucial. Medical journals, professional societies, and healthcare institutions should adopt and enforce consistent guidelines for reporting PVRI units. Additionally, increased education and awareness among healthcare professionals about the importance of correct PVRI units is essential.

Advancing Precision in PVRI Measurement and Reporting

As medical technology and understanding of cardiopulmonary physiology continue to advance, new methods for measuring and interpreting PVRI are emerging. These developments aim to improve the accuracy and reliability of PVRI measurements, potentially leading to more precise clinical decision-making.

What are some emerging technologies for PVRI measurement? Recent advances include:

• Non-invasive imaging techniques, such as cardiac MRI and echocardiography, for estimating PVRI
• Advanced computational models that account for pulsatile flow and vessel compliance
• Integration of machine learning algorithms to improve the accuracy of PVRI calculations based on multiple physiological parameters

These innovations hold promise for enhancing our understanding of pulmonary vascular dynamics and improving patient care. However, their widespread adoption will require rigorous validation and standardization to ensure consistent and accurate PVRI reporting across different clinical settings.

The Role of PVRI in Personalized Medicine

As healthcare moves towards more personalized approaches, PVRI is poised to play an increasingly important role in tailoring treatments to individual patients. By providing a quantitative measure of pulmonary vascular function that accounts for body size, PVRI can help clinicians make more nuanced decisions about patient management.

How might PVRI contribute to personalized medicine? Some potential applications include:

• Risk stratification for surgical procedures involving cardiopulmonary bypass
• Customization of pulmonary hypertension treatment regimens based on individual PVRI responses
• Prediction of long-term outcomes in patients with chronic cardiopulmonary diseases

As our understanding of the relationship between PVRI and various disease states grows, it is likely that this index will become an even more valuable tool in the personalization of patient care.

Challenges in Standardizing PVRI Measurement and Reporting

While the importance of standardizing PVRI measurement and reporting is clear, several challenges must be addressed to achieve this goal. These challenges include:

1. Variability in measurement techniques and equipment across different healthcare facilities
2. Differences in patient populations and clinical contexts that may affect PVRI interpretation
3. Lack of consensus on the most appropriate methods for indexing PVR to body size
4. Limited awareness among some healthcare professionals about the importance of correct PVRI units

How can these challenges be overcome? A multi-faceted approach is necessary, involving collaboration between professional societies, researchers, and clinicians. This may include:

• Development of comprehensive guidelines for PVRI measurement and reporting
• Implementation of quality control measures in clinical laboratories and research settings
• Integration of PVRI education into medical and nursing curricula
• Creation of user-friendly tools and software to facilitate correct PVRI calculation and unit conversion

By addressing these challenges, the medical community can work towards more consistent and accurate PVRI reporting, ultimately improving patient care and advancing our understanding of cardiopulmonary physiology.

The Future of PVRI in Clinical Practice and Research

As our understanding of pulmonary vascular dynamics continues to evolve, the role of PVRI in clinical practice and research is likely to expand. Future directions for PVRI application and research may include:

• Development of PVRI-based risk prediction models for various cardiopulmonary conditions
• Investigation of the relationship between PVRI and long-term outcomes in chronic diseases
• Exploration of genetic and environmental factors influencing PVRI
• Integration of PVRI into comprehensive cardiopulmonary assessment algorithms

How might advances in technology impact PVRI measurement and interpretation? Emerging technologies such as artificial intelligence and big data analytics could revolutionize our approach to PVRI. These tools may enable more sophisticated analysis of PVRI data, potentially uncovering new insights into pulmonary vascular function and disease progression.

The Importance of Continued Education and Awareness

As the significance of PVRI in clinical decision-making becomes increasingly apparent, ongoing education and awareness efforts are crucial. Healthcare professionals at all levels should be well-versed in the proper measurement, calculation, and interpretation of PVRI.

What strategies can be employed to enhance PVRI education? Some potential approaches include:

• Integration of PVRI-focused modules into continuing medical education programs
• Development of interactive online learning tools for PVRI calculation and interpretation
• Incorporation of PVRI case studies into clinical training scenarios
• Promotion of interdisciplinary collaboration to share knowledge and best practices related to PVRI

By prioritizing education and awareness, the medical community can work towards more consistent and accurate use of PVRI in both clinical practice and research settings.

Conclusion: The Path Forward for PVRI in Medicine

Pulmonary Vascular Resistance Index (PVRI) is a vital tool in cardiopulmonary medicine, offering valuable insights into pulmonary vascular function and informing critical clinical decisions. However, the current lack of standardization in PVRI reporting poses significant challenges to its effective utilization.

As we move forward, it is essential for the medical community to address these challenges through:

• Standardization of PVRI measurement and reporting practices
• Continued research into the clinical applications and implications of PVRI
• Development of advanced technologies for more accurate and non-invasive PVRI assessment
• Ongoing education and awareness efforts to ensure proper understanding and use of PVRI

By focusing on these areas, we can harness the full potential of PVRI as a powerful tool in personalized medicine, ultimately leading to improved patient outcomes and advancements in cardiopulmonary care. As our understanding of PVRI continues to evolve, it is likely to play an increasingly important role in shaping the future of cardiovascular and pulmonary medicine.

Pulmonary vascular resistance index: Getting the units right and why it matters

Clin Cardiol. 2019 Mar; 42(3): 334–338.

Published online 2019 Feb 27. doi: 10.1002/clc.23151

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Author information Article notes Copyright and License information Disclaimer

Pulmonary vascular resistance (PVR) and PVR index (PVRI) are key variables in a broad range of contexts, including prediction of outcomes in heart and liver transplantation, determining candidacy for closure of atrial or ventricular septal defects, and guiding treatment of pulmonary hypertension. Significant variability exists among the units used to report PVRI in current literature, making the interpretation of data and translation into clinical practice difficult. Here, we will review the measurement and derivation of PVR and PVRI and demonstrate the extent of confusion in the literature. We conducted a literature search of all published articles in PubMed using the term “PVRI. ” This yielded 218 sources with defined units for PVRI, including 33 unique variants. Among all reviewed literature, 45.4% of sources reported PVRI with units ending in m² (meters squared), which we defined as correct, whereas 54.6% reported PVRI with units not ending in m², which we defined as incorrect. This lack of uniformity has led to considerable confusion among researchers and clinicians, with potentially life‐altering consequences.

1.1. Pulmonary vascular resistance

Pulmonary vascular resistance (PVR) describes the resistance that blood must overcome to pass through the pulmonary vasculature. PVR index (PVRI) relates the absolute value of PVR to the patient’s body surface area to account for the effect of body size on blood flow.

Although imperfect, the hydraulic equivalent of Ohms law (where resistance = voltage/current) is the most practical formula for determining PVR.

PVR = pressure gradient/pulmonary blood flow.

PVR=mmHgmLmin−1/mLL−1=mmHgL−1min=1wood unitWU=80·dynes·sec·cm−5,

where pressure gradient = mean pulmonary artery pressure (mPAP) − mean pulmonary artery wedge pressure (PAWP). The accurate measurement of mPAP and PAWP is essential to achieving valid results. It is worth noting that considerable debate exists regarding the timing of PAWP measurement within the respiratory cycle.¹ Current consensus documents recommend that PAOP be measured end‐expiration.² However, some authors suggest that this approach may not represent the most physiological approach as variation across respiratory phases impacts pressure and resistance.¹, ³

If PAWP is not obtainable (eg, as may occur with pulmonary artery aneurysm), and assuming the absence of mitral stenosis, then mean left atrial pressure (LAP) may be substituted. Left ventricular end‐diastolic pressure (LVEDP) may also be used as a surrogate for PAOP in this scenario, but with 2 to 3 mm Hg higher values as end‐diastolic pressure is greater than mean diastolic pressure.

In the absence of intracardiac shunting, pulmonary blood flow (Qp) and cardiac output (CO) can be accurately measured using the thermodilution method. ¹ However, in the presence of a right‐to‐left shunt, the thermodilution method may be confounded by recirculation of the indicator (most often cold saline injectate) through the shunt or tricuspid regurgitation.⁴ In such cases, the Fick method can be used to determine Qp.

Fick equation:

Qp=oxygen consumption/(pulmonary vein oxygen content−pulmonary artery oxygen content).

It should be noted that recent studies have called into question the interchangeability of the thermodilution and Fick methods for the determination of cardiac output.⁵ Moreover, the accuracy of the Fick method is dependent on the proper assessment of oxygen consumption (VO2). VO2 can be determined through direct measurement or derived using empirical formulae. While both methods of VO2 determination are commonly used, most authors agree that measured VO2 is superior to estimated VO2 for the calculation of pulmonary blood flow.⁶, ⁷, ⁸ When comparing these methods directly, Chase et al found significant discrepancies between measured and estimated VO2 in the setting of heart failure with reduced ejection fraction. ⁹ Therefore, measured VO2 should be used whenever possible.

Next, oxygen saturations are obtained from the pulmonary veins (or from the left atrium or ventricle or assumed if necessary) and from the pulmonary arteries. The following formula is used to determine the oxygen content at each location:

Oxygen content=Hbg/dL×10dL/L×1.36mL/g×%saturation.

O2content=mL/L.

The difference between the pulmonary veins and arteries can then be determined through simple subtraction. All of the above equations can then be used to determine PVR.

1.2. PVR index

Clinicians often index units to express them in terms relative to the wide range of body surface area (BSA) among patients. Pediatric cardiologists have traditionally indexed flows based on the assumption that Qp changes proportionately with body surface area (BSA), while the trans‐pulmonary pressure gradient does not.¹⁰

Because indexing of PVR occurs relative to flow and because flow is in the denominator of the equation for PVR, the units of m⁻² change to m² when they are brought up to the numerator in the final result for PVRI:

PVRI=mmHgmLmin−1m−2/mLL−1=mmHgL−1minm2=WU·m2=80·dynesseccm−5m2.

In adult cardiology, the cardiac index (CI) is the most ubiquitous measurement reported, and its units are L min⁻¹ m⁻². PVRI, on the other hand, is correctly reported in units ending in m². We speculate that many authors incorrectly assume that PVRI is indexed as per m² or m⁻² because of their familiarity with CI.

A literature search for the term “PVRI” was conducted for all journal articles published between 1 January, 1980 and 3 April, 2018 using PubMed. Search results were screened for duplicates. The clinical context and units used to define PVRI were recorded for each source. Text, figures, and tables were checked for consistency. Units were recorded as published and then standardized to a common format for ease of classification.

Presumed typographical errors were checked against the remainder of text and figures. The units “U,” “IU,” and “UW” were presumed to imply Wood Units or Hybrid Resistance Units. Division signs and dashes implying “per unit” were converted to exponent format for consistency. Correct units for PVRI were defined as the following: WU m², mm Hg L⁻¹ min m², and or 80 dynes sec cm⁻⁵ m². Incorrect units were those with m² in the denominator or its equivalent (m⁻²), those that did not include m² in any form, and those that were mathematically nonequivalent to the correct unit definitions. Sources in which units for PVRI were ambiguous or undefined were recorded but not considered correct or incorrect.

Articles for which complete text or figures were unavailable (and did not state units used for PVRI within the abstract) were not included in the study. When no measurable units or ambiguous units were used to define PVRI, the entries were recorded as “ambiguous.” When different units were used to describe PVRI within a single article, each variant was recorded. Sources were classified as either pediatric or nonpediatric. Pediatric sources were defined as those published in pediatric journals or in which the study subjects were children (age < 18), or in which the primary citations were in pediatric journals. When present, the method used for measuring VO2 or calculating PVRI was also recorded.

The initial literature search yielded 326 unique articles in which PVRI was a key variable. Of these results, 94 were excluded because of lack of availability of the full article or text, and 14 were excluded because of ambiguous or undefined units. This yielded 218 sources with defined units for PVRI and full‐text availability. Forty‐five articles were determined to be pediatric in nature; 173 were deemed nonpediatric (Figure ).

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Flowchart demonstrating selection of journal articles for inclusion in this review

Among sources with defined units and full‐text availability, there were 33 unique variations of units used to define PVRI. Four literature sources used two or more units to define PVRI. Overall, the four most common units used to define PVRI were WU m² (24%), dynes sec cm⁻⁵ m² (22%), dynes sec cm⁻⁵ m⁻² (18%), and WU m⁻² (8%). The remaining 29 variants together made up 29% of all units used.

Among all literature, WU m² (n = 52) and dynes sec cm⁻⁵ m² (n = 48) were the most commonly used units to define PVRI, followed by dynes sec cm⁻⁵ m⁻² (n = 26) and WU m⁻² (n = 12) (Figure ).

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Incidence of units used to define pulmonary vascular resistance index (PVRI) in all literature. WU m² (n = 52) and dynes sec cm⁻⁵ m² (n = 48) were the most commonly used units overall in defining PVRI. The next most common units were dynes sec cm‐5 m⁻² (n = 39) and WU m⁻² (n = 18). WU, wood unit

Overall, there were more incorrect than correct units used to define PVRI. Among reviewed nonpediatric literature, 41.0% of articles correctly defined PVRI, while 59.0% were incorrect. Among reviewed pediatric literature, 62.2% of articles correctly defined PVRI, while 37.8% were incorrect. Among all reviewed literature, 45.4% of articles correctly defined PVRI, while 54.6% were incorrect (Figure ).

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Correct vs incorrect pulmonary vascular resistance index (PVRI) Units. Among nonpediatric literature, 41.0% of articles correctly defined PVRI, while 59.0% were incorrect. Among pediatric literature, 62.2% of articles correctly defined PVRI, while 37.8% were incorrect. Among all literature, 45.4% of articles correctly defined PVRI, while 54.6% were incorrect

Given that PVRI is incorrectly or ambiguously defined in the majority of reviewed literature, it is evident that significant confusion exists among the medical and scientific community. Compounding this issue further is the high degree of variability in the measurement of components used to determine PVRI, including VO2, pressure, and flow. The use of incorrect units or inconsistent measurements creates the potential for errors in clinical decision‐making and adverse patient outcomes.

One such example is the diagnosis of pulmonary arterial hypertension (PAH) and the decision of whether to recommend closure of a ventricular septal defect (VSD) or atrial septal defect (ASD) in the adult patient. Closure of a VSD or ASD in the setting of PAH (defined by the American Heart Association (AHA)/American Thoracic Society (ATS) 2015 Guidelines for Pediatric Pulmonary Hypertension as PVRI >3 WU m²) may lead to unacceptable mortality and morbidity, with complications including acute pulmonary hypertensive crisis, right ventricular failure, and respiratory failure.¹¹, ¹², ¹³ Conversely, failure to close a defect in an adult with nonprohibitive PAH may lead to decreased quality of life and shortened life expectancy.¹⁴ Using incorrect units for PVRI could lead to underdiagnosis of PAH and poor outcomes following closure of an ASD or VSD.

For example, a patient with a BSA of 2 m² and a measured PVR of 2 WU would have a PVRI of 4 WU m². However, if units ending in m⁻² are used to define PVRI (as we have seen is commonplace), then PVRI could be incorrectly reported as 1 WU m⁻².

Another example of clinical decision‐making involving PVRI is the assessment of candidacy for cardiac transplantation. Both the International Society for Heart and Lung Transplantation (ISHLT) and American Society of Transplant Physicians (ASTP) utilize PVR and PVRI in their listing criteria for cardiac transplantation as pulmonary hypertension has been associated with poor outcomes following cardiac transplantation.¹⁵, ¹⁶ Per ISHLT 2006 Guidelines for the Care of Cardiac Transplant Candidates and ASTP 1998 Listing Criteria for Cardiac Transplantation, a PVR of >5 WU and a PVRI of >6 WU are relative contraindications to cardiac transplantation.¹⁷, ¹⁸ The use of WU to define both PVR and PVRI is clearly erroneous. Recent literature citing the aforementioned sources correctly use WU m² to define PVRI, presumably expressing the original authors’ intent. ¹⁹

Other clinical areas where PVRI plays an important role include: choice of pharmacotherapy in the medical management of pulmonary hypertension, vasopressor selection in critically ill patients, and hemodynamic assessment in the perioperative period.²⁰, ²¹, ²², ²³

Thus, we contend that a concerted effort should be made by the editorial staff of academic journals and texts to encourage the use of consistent units to define PVRI. We believe that doing so will greatly facilitate the communication and comprehension of scientific literature and help to prevent erroneous diagnosis or clinical decisions.

The authors declare no potential conflict of interests.

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ABI/PVR – Richmond University Medical Center

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ABI/PVR Testing

If you are experiencing pain, trouble stopping bleeding, or worrisome symptoms affecting your legs, you may be suffering from peripheral artery disease. Luckily, this can be easily detected and diagnosed by an ABI/PVR test. At Richmond University Medical Center in Staten Island, New York, we offer this test as part of our comprehensive suite of cardiology evaluations. With the results, we can ensure an accurate diagnosis and prescribe the most effective treatment.

What Is an ABI/PVR?

The pulse volume recording (PVR) test is a diagnostic tool that uses blood pressure cuffs and hand-held ultrasound devices to obtain information about blood flow in your arms or legs. One specific type of PVR is called an ankle-brachial index (ABI) test. As part of this test, your physicians will use the information gained from the PVR to compare your blood flow in your arms and legs to check for any disparities.

An ABI/PVR is mainly used to evaluate patients for peripheral artery disease (PAD), which is characterized by arterial blockages in the legs. Normally, the blood pressure in all your limbs should be the same. If your legs have less blood flow, that is a sign that the arteries are blocked or narrowed by PAD.

The ABI/PVR Procedure

Richmond University Medical Center does not require any special preparations for patients getting an ABI/PVR. We do recommend wearing shorts, a short-sleeved shirt, and shoes that are easy to remove, as you will need to expose your arms and legs for the test.

An ABI/PVR test involves the following procedure:

• You will be asked to expose your arms and legs and sit or lie down on an examining bed.
• Blood pressure cuffs will be applied to your arms and legs and inflated.
• The technician will press a handheld wand called a transducer to the skin on your arms and legs. This will measure blood pressure flow through ultrasound waves.

The entire ABI/PVR test will take 30 to 90 minutes to complete. While you may experience mild discomfort from the pressure cuffs, the test is perfectly safe and has no associated risks. You will be able to resume your daily activities immediately after the test is complete.

When to Get Tested

The physicians at Richmond University Medical Center are likely to administer an ABI/PVR if you are experiencing symptoms of PAD, which include:

• Pain, weakness, coldness, or heaviness in your legs
• Less leg hair than normal
• Discolored skin that’s bluish or abnormally pale
• Impaired healing of leg and foot injuries
• Slow toenail growth

Your physician may also administer the test if you are not experiencing any symptoms but face an increased risk of PAD. Higher risks of PAD can come with a history of smoking, elevated cholesterol, high blood pressure, and diabetes. If you think you may be at risk, speak with your physician.

Schedule Cardiology Testing Today

Tests like an ABI/PVR are tools that are essential to accurately diagnosing your ailment and ensuring a fast and effective treatment. At Richmond University Medical Center, our cardiology physicians utilize their expertise to administer ABI/PVR tests and correctly analyze the results. To make your appointment in Staten Island, contact us today.

PVR IU – what’s new?

Larisa Fefilova, Chairman of the PMC of the Udmurt Republic

The year 2017 was marked for the penitentiary system by the introduction of new internal regulations for correctional institutions. What did they bring to the life of prisoners? I decided to see what innovations the new PVR contains and express my point of view on them. I decided to start with negative changes.

I think it is worth paying attention to paragraph 16, which specifies the duties of convicts. Among other things, the prisoner is now obliged to appear when summoned by the administration of the correctional colony and give written explanations on the execution of the sentence, as well as give written explanations on the facts of violation of the established procedure for serving the sentence (in case of failure to appear, the prisoner may be subjected to forcible bringing). This innovation was introduced in the new temporary detention centers after numerous controversial situations between prisoners and human rights activists, on the one hand, and jailers, on the other hand. In many regions, the reason for the imposition of punishment was the refusal of the prisoner to appear at the request of the administration and give written explanations on the fact of the written report. And in this place there were disputes whether the imposition of this penalty is legal, if this requirement is absent in the law. Now these disputes are resolved. But one “but” remains, I understand that, on the basis of the new norm, now the prisoner is obliged to appear at the request of the administration, but what about Art. 51 of the Constitution – “no one is obliged to testify against himself”? Or does this rule no longer apply to prisoners? And will there be a new one among the reasons for imposing disciplinary sanctions – “refusal to give explanations in writing on the fact of violation of the established procedure for serving a sentence”?

The duty of a prisoner to “monitor the correspondence of inventories of personal belongings of convicts in duffel bags to their contents” causes “tenderness”, while (innovation!) You can have tobacco products no more than 2 packs of cigarettes, matches – 1 box. I don’t understand how the restriction in the number of tobacco products is justified, but I see exactly the situations that will arise. First, there will be an increase in the need (an increase in the number of trips!) of prisoners to the warehouse, to the so-called “kapterka”, and in most institutions these trips are limited in the number and time of visits (sometimes sometimes once or twice a week). There will be problems with visiting the “kapterka” to get cigarettes. In this case, the inventory will have to be corrected at each next visit in accordance with the seized. What will the inventory look like after a month of use?! By the way, the prisoners will now be charged with the duty to monitor the condition of the badges on the breastplate.

One of the important negative, from my point of view, innovations in the Rules – paragraph 17, convicts are prohibited from harming their health. If previously self-mutilation was usually the last available means for prisoners to express their disagreement with the excesses of the jailers, now it has been given the form of a violation. He cut his veins – sat in a punishment cell, swallowed a “hedgehog” – “stomp” in OSUON.

On the one hand, it is gratifying that prisoners are no longer obliged to call the staff of the institution “citizen”, “citizen”. But on the other hand, through the entire text of the Rules, the obligation of the prisoner is carried out “upon request, as well as at the entrance to the office premises (offices) or when contacting the administration of the correctional institution, convicts are required to introduce themselves, give their last name, first name, patronymic (if any), date of birth, articles of the Criminal Code of the Code of the Russian Federation, according to which they were convicted, the beginning and end of the term of punishment, the number of their detachment (cell). It’s all right, maybe employees need to know this information, but why should this information be reported to representatives of the prosecutor’s office, state authorities and public organizations that control the activities of correctional institutions and penitentiary institutions? I do not need to know under what article the person who turned to me as a representative of public control was convicted, and the terms of serving his sentence. And why this information to the prosecutor’s office? Commissioner for Human Rights? To consider the content of the complaint differently depending on the article and the term? Everything would be fine, but the staff will require the prisoners to state all the above information to the members of the PMC when visiting institutions, and I will be forced to listen to all this “nonsense” that I do not need. But to my protests, the jailers will refer to the Rules and duties of the prisoner, and if the latter is limited to only the full name, the employees will have a reason to impose a penalty on the prisoner. Approximately such a story was before the new Rules: the cell duty officer is obliged to report all his data, and I cannot interrupt the convict until he finishes his entire “report”. Employees always answer all my protests: according to the law it is necessary, let them “report”.

Chapter VI “Involvement of convicts to work (divorce and removal from work)” again does not regulate the issue of work clothes for prisoners – in what we live, in that we work. Taking into account that the clothes of the established sample for everyday wear, prisoners are issued only two sets for a long period … However, paragraph 25 establishes the obligation of prisoners to work in clothes that are issued for everyday wear by prisoners: “When divorcing for work, it is checked whether all convicts are shod and dressed according to the season and the established form. Persons dressed out of uniform are returned to eliminate violations in clothing. On the one hand, the state indicates the permitted length of hair and beard to the prisoner up to a millimeter (clause 16, hair length up to 20 mm, beards – 9mm), on the other hand, the desire to restrict prisoners in overalls defies any logic. What kind of hygiene can we talk about? Both at work and in the hostel, everyone wears the same clothes. And what kind of rule, reflected in paragraph 28, provides that for refusal to work or termination of work may result in the application of penalties and liability? How, based on what standards, will liability be calculated? What is it? Lost profit? In the number of unfulfilled shift tasks ..?

P.94 worsens the situation of prisoners, since The Ministry of Justice of the Russian Federation, following the order of the Russian Post, introduces restrictions on investments in parcels. Now only low-value printed publications, photographs and manuscripts can be sent in parcels. Previously, there were no restrictions on investments in parcels, prisoners could receive the necessary things and products: sweets, coffee, socks, slippers, etc. Now the prisoners are deprived of this.

In paragraph 157, the punishment for smokers was toughened. Previously, smoking was prohibited in ShIZOs with reference to fire safety, but there was no such ban in other cell-type premises. In the new document, smokers in ShIZO remained a complete ban on smoking, while the rest were allowed to smoke only during a walk.

Clause 168 introduced a restriction that previously applied only to prisoners held in a pre-trial detention center: to negotiate, transfer any items to persons held in other cells or other premises of the ShIZO, PKT, EPKT, solitary confinement, to chat or correspond with them. The ban on “inter-chamber communication” is understandable and justified in the pre-trial detention center, which is necessary so that accomplices in a crime cannot collude in their criminal case and agree on positions in order to avoid punishment, or put pressure on the “accomplice”. Why is this restriction introduced in the colonies?

On some points I cannot decide whether the innovation is positive or negative.

Clause 23 the number of check-ups at least twice a month during non-working hours of all convicts is increased, during which their appearance is checked, including the condition of clothes, shoes and haircuts. Previously, there was a norm once a month and, in addition to clothes and shoes, hairstyles were added.

The New Rules (clause 16) approved the bed dressing pattern, previously this issue caused considerable controversy due to the fact that there is no established dressing pattern in nature, however, there is a requirement for non-fulfillment of which penalties are imposed. Whether that’s good or bad, I don’t know. By the way, in the scanned version of the PVR IU, the installed sample is not visible at all. On the one hand, the convicts are not in the army, why this “bells and whistles”, the main thing is that the bed should be neatly made. But I expect that there can be only positive emotions on the part of the penitentiary staff – we teach prisoners to order.

A new chapter appeared in the TAP “Peculiarities of keeping convicts in transit points”. I can’t say enough good things about this chapter.

The changes begin by describing in more detail the process of admitting a prisoner to an institution. This is the weighing of things that are with the prisoner, the right to choose which things the prisoner wants to keep with him, and which are sent to the warehouse and stored until release; an inventory of the prisoner’s personal belongings is made. The procedure for a personal search is described in more detail: it is carried out only by a person of the same sex, carried out in the correct form, excluding harm to the health of the convict, within the limits necessary to detect prohibited items and substances. The term for the medical examination is one day.

Further, a more detailed description of the procedure for distributing prisoners from the quarantine department into squads appeared. This was not the case before in the TAP of the PS.

Well, I would like to reflect the positive aspects of the Rules:

A wonderful change about the right of prisoners to bathe, now it is required at least twice a week (paragraph 21).

The term for censorship of letters received and sent by prisoners is limited to no more than three working days, and if letters, postcards and telegrams are written in a foreign language – no more than seven working days (p. 58). Now, before the adoption of this norm, letters were delayed not only for weeks, but for months. And there was always a reference to the censor, he has a large amount of work, he does not have time. Now he will be forced to keep up with the deadlines established by law, and this is wonderful.

In the same paragraph, a very good addition to resolving the issue of sending proposals, applications, petitions and complaints of convicts addressed to supervisory authorities and human rights institutions. Now the Rules establish that if the prisoner does not have funds on his personal account, such appeals are sent at the expense of the PS.

The deadline for the transfer of appeals of convicts to telecom operators is set no later than one working day (excluding weekends and holidays).

Attention should be paid to a significant addition on the issue of prisoners’ applications: on acceptance of proposals, applications, petitions and complaints, the convict is issued a receipt on behalf of the prison administration indicating the date the complaint was transferred to the representative of the prison.

A rule has been introduced to notify a prisoner of the receipt of funds to his personal account – no later than 3 days from the moment they are received, such a rule was not previously in the PVR of the penitentiary.

If the convict wants to transfer personal money to close relatives and other persons, it is no longer necessary to indicate the reason why he expressed a desire to transfer money. And the transfer itself is carried out in accordance with the Instructions for accounting for personal funds and other valuables. It was clarified that the convict is informed about the sending of the money transfer against signature on the receipt, which is attached to the prisoner’s personal file.

Clarified the weather conditions under which inspections are carried out indoors (item 42): rain, snow, with strong gusts of wind, temperature drop below 25 degrees Celsius.

When moving groups of convicts, the drill step is not used, a very remarkable clarification, since in practice this technique was used in some colonies.

An important addition about the duty of the administration of the correctional facility to bypass the cells on a daily basis and receive from convicts in ShIZO, PKT, EPKT, general and solitary cells, a safe place and locked rooms under strict conditions for serving sentences, the CCI, proposals, statements, petitions and complaints, as in written as well as oral form.

Finally, the procedure for calculating the term for granting visits, receiving transfer when transferring a convict from one condition to another is explained – from the date of granting the last visit and receiving the last transfer in the previous conditions of serving the sentence.

A new paragraph has been introduced into Chapter XIV “Procedure for granting visits to convicts”, meetings with clergymen and performing religious rites, use of cult objects and religious literature.

Together with the positive changes, the paragraph was removed from the above chapter specifying the conditions for granting a long visit with other persons, in which it was indicated that they are provided only in cases where, in the opinion of the administration, such visits will not adversely affect the convict.

A very important addition has appeared (p. 134) during quarantine, and if visiting a patient can lead to a deterioration in his health, the head of the health facility, on the written opinion of the attending physician and the head of the department, temporarily suspends meetings with him, except for lawyers and persons entitled to to provide legal assistance.

As for the changes in the content in the ShIZO, a significant positive moment appeared – they were allowed to use a mug during the day, previously there was a complete ban on dishes in the ShIZO, except for meals. One thing is not clear, in connection with what is it possible to have only an aluminum mug in the ShIZO? What’s wrong with a stainless steel or plastic mug?

Clarified the controversial issue of offsetting the terms of ShIZO, PKT, EPKT, solitary confinement while in a pre-trial detention center. The term of stay in a pre-trial detention center does not count towards the term of serving a sentence in a ShIZO, PKT, EPKT.

An interesting point appeared in paragraph 172 of convicts serving their sentences in light conditions in correctional colonies of general regime, in order to successfully socialize, by order of the head of the penitentiary six months before the end of the sentence, they can be released from custody, if necessary the nature of the work being done. It remains only for the prisoner to find such a job.

A very important positive innovation in the Rules is the appearance of a separate Chapter XXVIII “Peculiarities of Detention of Disabled Convicts”, which details the rights of prisoners with disabilities.

The list of things and items, food that convicts are prohibited from carrying, receiving in parcels, parcels, parcels or purchasing has also undergone changes:

Clause 3 flying vehicles.

Item 14 is supplemented in addition to piercing and pointed objects, objects and containers made of glass, ceramics and metal are prohibited (except for aluminum spoons, forks, mugs, plates and canned foods in metal containers).

Prisoners were forbidden to have television receivers with access to the information and telecommunications network “Internet” and built-in media players, electronic media and storage media. As well as educational videos on topography, service dog breeding, martial arts, training of fighters of special units, mountain training and parkour, weapon construction, the manufacture of explosives, poisonous, poisonous, narcotic and potent substances. Prisoners are prohibited from reading literature, documents or information on any medium that calls for the implementation of extremist activities or justifies the need to carry out such activities.

In the “old” Rules there were no restrictions on the power of boilers that prisoners had the right to have with them, but now the power of electric boilers is limited to no more than 0.5 kW.

Of the positive changes, only an exception to the rules of the ban on wearing wrist and pocket watches in prisons.

True, convicts held in light conditions of detention and in colonies-settlements are allowed to use: audio players without a recording function, technical devices for reading electronic books without an Internet access function and an audio and video recording function in the amount of no more than one device of each type per convict; DVD and audio players may be installed in public places.

And yet, in the PKT and EPKT, the previously incomprehensible existing ban on tea and coffee was canceled. Now prisoners who are in locked rooms will be able to drink these drinks, now the question arose of the implementation of this “new” right, in accordance with the law, there are no sockets in these rooms, how to brew boiling water? There is no mention of this in the Rules.

And finally, I still didn’t understand what caused and how to understand the change in the weight of things, objects and food that a prisoner can have with him: in clause 5 of the PVR PS, up to 50 kg is indicated, and at the end of the rules in the Notes to Appendix No. 1, the total weight of things and objects belonging to the convict, food products “shrinks” to 36 kg.

Ryazan PVR was examined by a delegation from the heads of the working apparatus

Ryazan PVR was examined by a delegation from the heads of the working apparatus of the Commissioner for Human Rights in the Russian Federation

on Saturday, March 5, a delegation from the heads of the working apparatus of the Commissioner arrived in the Ryazan region with a working visit. on human rights in the Russian Federation. The delegation includes the deputy head of the working apparatus of the HRC of the Russian Federation, Major General Sergey Futo and Tatiana Reikhman, adviser to the HRC of the Russian Federation.

The guests came to the region on behalf of Tatyana Moskalkova, Commissioner for Human Rights in the Russian Federation, in order to communicate with the residents of Lugansk and Donetsk, to find out their real needs and needs.

Accompanied by the Commissioner for Human Rights in the Ryazan Region, Natalya Epikhina, the members of the delegation visited several PVDs, talked to citizens in them, as well as to Ryazan doctors, teachers and volunteers who help people get through this difficult time.

Sergey Futo noted that more than 140,000 citizens of the LPR and DPR are now on the territory of the Russian Federation. For them, 900 temporary accommodation points have already been created in different subjects of the RV.

“The Ryazan Region is among the leaders,” said Sergei Romanovich. – From the very first day you have declared a high alert regime. Now there are actually seven points in the region, in which there are about 700 people.

Today we looked at the conditions in TACs, they are good both for life and for medical care. And most importantly, so that people can breathe freely and feel the help provided by the Russian Federation. Thanks to the actions of the Government of the Ryazan region, almost everything necessary for people has been created here.

Many of those who came here plan to stay in Russia and obtain citizenship, while others want to return to their homeland as soon as possible. But the main thing is that people got a respite and the opportunity to save the most important thing – life, to create conditions for their parents and children,” Sergey Futo emphasized.

Tatyana Reikhman, in turn, noted that from the point of view of providing medical care in Ryazan TACs, everything is organized at the proper level. For arriving citizens, both the initial examination and the necessary assistance in the hospital are organized.