Pedal blood flow and transcutaneous PO2 in normal subjects and in patients suffering from severe arterial occlusive disease.

Abstract

Pedal transcutaneous partial pressure of oxygen (tcPO2) has been measured by polarographic method, heating the skin at 44 degrees C. In 50 normal subjects, mean tcPO2 measured 54.5 +/- 7 mmHg. Among 43 patients suffering from chronic ischaemia of lower limbs, mean tcPO2 measured 40.8 +/- 8 mmHg in patients with from claudication and 16.1 +/- 15 mmHg in patients suffering from rest pain and/or gangrene. The variability of repeated tcPO2 measurements, expressed as 1 SD of the mean, was 4.5 mmHg in normal subjects and 2.9 mmHg in patients. The relationships between pedal subcutaneous blood flow measured in xenon-133 clearance method and pedal tcPO2 have been studied in nine normal subjects and in five patients suffering from severe chronic ischaemia of lower limbs (rest pain and/or gangrene). There was a positive correlation between blood flow and tcPO2 in normal subjects (r = 0.77, P less than 0.001). In patients suffering from severe ischaemia, there was no correlation between these two parameters, but measured blood flow was sometimes very high in areas where tcPO2 was low. It is likely that 133Xe clearance method considerably overestimates local blood flow in these patients, because there is considerably less fat in subcutaneous tissue of chronic severely ischaemic areas. Thus, partition coefficient should be determined in each patient. However, tcPO2 may constitute an index of nutritional circulation, while 133Xe clearance actually measures total subcutaneous blood flow.