Skin Blood Flow In Patients Research Articles

Laser Speckle Contrast Imaging-based diagnosis of severe mesenteric traction syndrome: Hemodynamics and prostacyclin - A prospective cohort study.

Today, the diagnosis and grading of mesenteric traction syndrome relies on a subjective assessment of facial flushing. However, this method has several limitations. In this study, Laser Speckle Contrast Imaging and a predefined cut-off value are assessed and validated for the objective identification of severe mesenteric traction syndrome. Severe mesenteric traction syndrome (MTS) is associated with increased postoperative morbidity. The diagnosis is based on an assessment of the developed facial flushing. Today this is performed subjectively, as no objective method exists. One possible objective method is Laser Speckle Contrast Imaging (LSCI), which has been used to show significantly higher facial skin blood flow in patients developing severe MTS. Using these data, a cut-off value has been identified. This study aimed to validate our predefined LSCI cut-off value for identifying severe MTS. A prospective cohort study was performed on patients planned for open esophagectomy or pancreatic surgery from March 2021 to April 2022. All patients underwent continuous measurement of forehead skin blood flow using LSCI during the first hour of surgery. Using the predefined cut-off value, the severity of MTS was graded. In addition, blood samples for prostacyclin (PGI2) analysis and hemodynamics were collected at predefined time points to validate the cut-off value. Sixty patients were included in the study. Using our predefined LSCI cut-off value, 21 (35%) patients were identified as developing severe MTS. These patients were found to have higher concentrations of 6-Keto-PGFaα (p=0.002), lower SVR (p<0.001), lower MAP (p=0.004), and higher CO (p<0.001) 15min into surgery, as compared with patients not developing severe MTS. This study validated our LSCI cut-off value for the objective identification of severe MTS patients as this group developed increased concentrations of PGI2 and more pronounced hemodynamic alterations compared with patients not developing severe MTS.

Skin Blood Flow in an Area at Risk for Pressure Sore

The aim of this study was to measure skin blood flow in patients with pressure sore in a long-term care unit. For comparison, measurements were also carried out on in-patients at risk of developing pressure sores and on healthy individuals in the same age groups as the in-patients. Skin blood flow was measured in the morning, using a laser-Doppler flowmeter. Measurements were made over the lateral part of the hip and over the lateral part of the upper arm. Measurements were carried out first at ambient temperature. The flow was then followed as the local skin region was heated to 40 degrees C. The results indicate that in healthy individuals the heat stimulus increased skin blood flow over the lateral part of the hip more than in in-patients in the same age group. Individuals below the age of 60 have a greater response than those over the age of 60. This impairment in the ability of the older in-patients to increase skin blood flow in response to thermal stimulus may be a factor in the development of pressure sores.

Skin Blood Flow in Patients With Stage 5 Chronic Kidney Disease on Hemodialysis

We have shown previously that skin perfusion is reduced in patients with diabetes mellitus (DM). Patients with diabetes and with chronic kidney disease (CKD) stage 5 were having advanced microangiopathy. In this cross-sectional study, we measured skin blood flow in DM and non-DM patients on dialysis to assess whether any differences exist in skin perfusion in those 2 groups of patients. A total of 25 patients with DM (aged 59.9 +/- 2.2 years) and 24 patients with non-DM CKD stage 5 (44.6 +/- 2.9 years) on hemodialysis (HD) were studied. Ten healthy subjects (37 +/- 4.3 years) were used as a control group. Skin blood flow (SBF) was measured using Vasamedic Model 403B laser Doppler device (Vasamedics Inc., St. Paul, MN) in a standardized way at the plantar and dorsal surface of the finger and toe and at the pretibial surface of the leg at 2 different local skin temperatures of 35 degrees C and 44 degrees C. Laboratory biochemical data were collected at the time of SBF study. The SBF measured at 35 degrees C was lower in the patients with DM on dialysis as compared with healthy subjects and non-DM dialysis patients. The SBF response to the increase in temperature of the probe to 44 degrees C was 70% to 80% lower in DM patients as compared with healthy subjects and non-DM patients. However, non-DM subjects who displayed SBF similar to control subjects at 35 degrees C, had impaired response in SBF at 44 degrees C as well. Patients with lower serum albumin exhibited lower SBF even after adjustment for age. SBF is impaired in patients with stage 5 CKD on HD, particularly in those with DM as a cause of CKD. SBF negatively correlated with age and albumin (nutritional status) in DM and non-DM patients with stage 5 CKD on HD. Measurement of SBF can be useful in the evaluation of vasculopathy in CKD population and can potentially be used for assessment of vascular response during specific clinical intervention.

Non-linear analysis of skin blood flow in patients suffering from chronic venous leg ulcers

SummaryThe elevated ambulatory pressure in the peripheral venous system in patients suffering from chronic venous insufficiency manifests itself not only in the form of disturbed macrocirculation but also and particularly in microangiopathic changes. Laser Doppler fluxmetry is a well established method to measure cutaneous blood flow. Aim of the study was to investigate the cutaneous vasomotion at the inner ankle in patients suffering from chronic venous insufficiency in the clinical stadium C6 compared to healthy subjects. Patients, methods: In 38 patients suffering from venous ulcer and in 33 healthy subjects continous time series of Laser Doppler fluxmetry (LDF) data were recorded with a sampling frequency of 50 Hz over a period of 15 min. The patients were supine and LDF was measured at the inner ankle. Time series were analyzed using newly developed methods (wavelet analysis and biorthogenal decomposition). Results: There was a statistically significant difference in mean LDF between patients and healthy controls (94 SD 65 AU [C6] vs. 28 SD 13 AU (C0), p &lt; 0.001). There also were statistically significant differences in the scaling levels using wavelet analysis corresponding to sympathetic activity, corresponding to myogenic activity in the vessel wall and corresponding to the heart beat. Conclusion: There are changes in vasomotion between patients with venous ulcers and healthy controls. We found a vasale neuropathy and a high degree in dysregulating skin perfusion. The new innovative strategies are suited for describing microcirculation and controlling therapies.

The effect of α‐lipoic acid on symptoms and skin blood flow in diabetic neuropathy

Multiple pathogenic pathways are involved in diabetic neuropathy and diverse treatments have been tried without success. The aim of this study was to assess the effect of alpha-lipoic acid on skin blood flow in patients with diabetic neuropathy. We measured skin blood flow in 13 control subjects and 19 patients with diabetic neuropathy using the laser Doppler blood flow technique. Skin blood flow and the extent of skin blood flow changes were compared before and after diabetic patients received 600 mg/day alpha-lipoic acid intravenously for 14 days. Although no significant differences in absolute values of skin blood flow or in the extent of changes were noted, symptoms were reduced after alpha-lipoic acid treatment. This study suggests that alpha-lipoic acid, a potent antioxidant, improves symptoms of diabetic neuropathy. Larger studies are needed to determine whether improvements in skin blood flow also occur in patients with diabetic neuropathy.

Failure of Doppler ankle pressure to predict healing of conservative forefoot amputations.

Fifty minor foot and transmetatarsal amputations were studied to assess the reliability of Doppler ankle blood pressure (DABP) and skin blood flow (SBF) to predict healing. The level of amputation was determined solely on clinical criteria. Thirty-six (72 per cent) of the amputations healed. There was no statistical difference between mean DABP in healed 89 +/- 8 mmHg mean +/- s.e.m.) and non-healed (91 +/- 12 mmHg mean +/- s.e.m.) amputations. SBF was assessed by 125I-iodoantipyrine clearance in 28 patients. There was no correlation between DABP and SBF (r = 0.038). SBF in patients with healed amputations was 14.8 +/- 1.2 (mean +/- s.e.m.) ml 100 g-1 min-1 in contrast to SBF of 5.9 +/- 0.3 (mean +/- s.e.m.) ml 100 g-1 min-1 in the patients with non-healing (P less than 0.01). Where the flow was in excess of 8 ml 100 g-1 min-1 healing was always obtained while a flow of less than 7 ml 100 g-1 min-1 was associated with healing failure. These results suggest that DABP should be interpreted with caution as this technique fails as an accurate means of identifying those patients suitable for forefoot amputations. Skin blood flow assessment appears to provide an absolute value for the prediction of healing potential at this level.

Hemodynamic effects of intermittent pneumatic compression in patients with critical limb ischemia

Traditional teaching assumes that the distal arterial tree is maximally dilated in patients with critical limb ischemia (CLI). Endovascular or arterial bypass procedures are the commonly used interventions to increase distal perfusion. However, other forms of treatment such as spinal cord stimulation or intermittent pneumatic compression (IPC) have been shown to improve limb salvage rates. This prospective study was designed to determine if the use of IPC increases popliteal, gastrocnemial, collateral arterial, and skin blood flow in patients with CLI. Twenty limbs with CLI in 20 patients (mean age, 74 years) were evaluated with duplex ultrasound scans and laser Doppler fluxmetry in the semi-erect position before, during, and after IPC. One pneumatic cuff was applied on the foot and the other on the calf. The maximum inflation pressure was 120 mm Hg and was applied for 3 seconds at three cycles per minute. All patients had at least two-level disease by arteriography. Fourteen limbs were characterized as inoperable, and six were considered marginal for reconstruction. Flow volumes were measured in the popliteal, medial gastrocnemial, and a genicular collateral artery. Skin blood flux was measured on the dorsum of the foot at the same time. Significant flow increase during the application of IPC was found in all three arteries (18/20 limbs) compared with baseline values (P < .02). The highest change was seen in the popliteal, followed by the gastrocnemial and the collateral artery. After the cessation of IPC, the flow returned to baseline. This was attributed to the elevation of time average velocity, as the diameter of the arteries remained unchanged. The skin blood flux increased significantly as well (P < .03). In the two limbs without an increase in the arterial or skin blood flow, significant popliteal vein reflux was found. Both limbs were amputated shortly after. IPC increases axial, muscular, collateral, and skin blood flow in patients with CLI and may be beneficial to those who are not candidates for revascularization. Patients with significant venous reflux may not benefit from IPC. This supports the theory that one of the mechanisms by which IPC enhances flow is by increasing the arteriovenous pressure gradient.

Spinal cord stimulation does not change peripheral skin blood flow in patients with neuropathic pain

Spinal cord stimulation does not change peripheral skin blood flow in patients with neuropathic pain

Effects of Spinal Cord Stimulation on Nutritional Skin Blood Flow in Patients with Ischemic Pain

Effects of Spinal Cord Stimulation on Nutritional Skin Blood Flow in Patients with Ischemic Pain

Distribution of breast skin blood flow in patients with breast cancer

Abstract Highly vascularized tumours are associated with fast growth and high grade. Accurate, objective assessment of skin blood flow in the breast can be obtained by the recent development of a laser Doppler imager (LDI) that creates an image of tissue blood flow over a wide area. The imager collects flow data without touching the breast skin. Breast skin blood flow was mapped using the LDI in an outpatient clinic on 100 patients (47 normal, 26 benign breast disease and 27 breast carcinoma). The findings were correlated with the results of examination by mammography/ultrasound and cytology/histology. The LDI blood flow images of the normal breasts were analysed in five breast regions (four quadrants and central area) and flow values for each region were averaged. The mean blood flow in normal patients was 299 ± 155 and 311 ± 157 flux (± SD) for the right and left breasts, respectively. In patients with benign breast disease it was 476 ± 210 flux and in patients with breast carcinoma it was 685 ± 278 flux. Breasts with carcinoma show the highest skin blood flow measurements. Our findings indicate that the technique is sensitive for large cancers. This new tool may have an application in the serial monitoring of early response to systemic treatment in patients with large superficial tumour masses.

Effect of dialysis on the power spectra of heart rate, blood pressure and forehead skin blood flow in patients with chronic renal failure

Effect of dialysis on the power spectra of heart rate, blood pressure and forehead skin blood flow in patients with chronic renal failure

Laser doppler imaging of finger skin blood flow in patients after microvascular repair of the ulnar artery at the wrist

Laser Doppler imaging is a new, non-invasive technique allowing the spatial distribution and the temporal variation of the skin blood flow to be monitored. A mean blood flow value over an area, such as the finger-tip in the present study, can also be calculated. Recordings from 12 patients with a sutured ulnar artery following trauma did not significantly differ from those obtained in 14 controls. Four patients with a ligated ulnar artery, however, showed a slower restitution of blood flow values after cold provocation. All sutured ulnar arteries were found to be patent, which confirms that microvascular reconstruction of an injury to the ulnar artery at the wrist is worthwhile.

The effect of aging and arteriosclerosis on human skin blood flow

Skin blood flow in the deltoid region of 65 men was measured by the xenon 133 clearance method and in studying the correlation of age, total cholesterol and systolic blood pressure to skin blood flow, the following results were obtained. (1) Skin blood flow significantly decreased with increase in age. In calculating skin blood flow at 20 and 70 years of age from the regression line between skin blood flow and age, it was estimated that skin blood flow at 70 years of age decreased to 40% of that at 20 years of age. (2) Skin blood flow significantly decreased with increase in total cholesterol and systolic blood pressure. (3) Skin blood flow showed the closest correlation with age, followed by total cholesterol and systolic blood pressure which showed a weak correlation. It is estimated from the foregoing results that as skin blood flow in patients with arteriosclerosis decreases more in elderly individuals than in young persons, their wound healing is delayed.

The effects of thromboxane receptor blockade on platelet aggregation and digital skin blood flow in patients with secondary Raynaud's syndrome

Raynaud's syndrome (RS) is characterized by intense blood vessel spasm resulting in finger blanching. Treatment primarily involves vasodilation. Thromboxane A2 (TXA2) has been shown to be a potent vasoconstrictor and platelet aggregant. It may be possible to produce a vasodilatory and anti-thrombotic effect by blockade of the TXA2 receptors. ICI 192,605 is a potent TXA2 receptor antagonist and we studied its effects on platelet aggregation and digital blood flow in patients with RS. Sixteen patients with RS completed this double-blind, randomized, placebo controlled study. Each patient was seen on three separate occasions and was given ICI 192,605 (100 mg orally) on one occasion and matching placebo tablets on the other two. We measured platelet aggregation using platelet rich plasma (PRP) stimulated by U46619, a thromboxane (TX) mimetic. The concentration of U46619 required to cause just over 50% platelet aggregation before the administration of either ICI 192,605 or placebo (pre-dose) was noted. The same concentration of U46619 was used to stimulate the PRP sample at 1 h after the administration of ICI 192,605 or placebo (post-dose) and the percentage of platelet aggregation was again noted. Fingertip skin blood flow was also measured 1.25 h post-dose using a laser Doppler flowmeter. Patients were seated in a temperature controlled chamber which was initially heated to 40 degrees C to induce centrally mediated vasodilatation. The temperature was then lowered to 12 degrees C followed by rewarming to 40 degrees C. Steady blood flow values at these temperatures were measured and the rates of cooling and rewarming were also noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Beneficial Effects of Oestrogen Replacement Treatment in Normalising Skin Blood Flow in Patients with Syndrome X

Conference Abstract| March 01 1991 Beneficial Effects of Oestrogen Replacement Treatment in Normalising Skin Blood Flow in Patients with Syndrome X G M C Rosano; G M C Rosano 1Department of Cardiac Medicine National Heart & Lung Institute, Dovehouse street, London SW3 6LY UK Search for other works by this author on: This Site PubMed Google Scholar D C Lindsay; D C Lindsay 1Department of Cardiac Medicine National Heart & Lung Institute, Dovehouse street, London SW3 6LY UK Search for other works by this author on: This Site PubMed Google Scholar P M Sarrel; P M Sarrel 1Department of Cardiac Medicine National Heart & Lung Institute, Dovehouse street, London SW3 6LY UK Search for other works by this author on: This Site PubMed Google Scholar P A Poole-Wilson P A Poole-Wilson 1Department of Cardiac Medicine National Heart & Lung Institute, Dovehouse street, London SW3 6LY UK Search for other works by this author on: This Site PubMed Google Scholar Clin Sci (Lond) (1991) 80 (s24): 9P–10P. https://doi.org/10.1042/cs080009Pc Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Cite Icon Cite Get Permissions Citation G M C Rosano, D C Lindsay, P M Sarrel, P A Poole-Wilson; Beneficial Effects of Oestrogen Replacement Treatment in Normalising Skin Blood Flow in Patients with Syndrome X. Clin Sci (Lond) 1 March 1991; 80 (s24): 9P–10P. doi: https://doi.org/10.1042/cs080009Pc Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search nav search search input Search input auto suggest search filter All ContentAll JournalsClinical Science Search Advanced Search This content is only available as a PDF. © 1991 The Biochemical Society and the Medical Research Society1991 Article PDF first page preview Close Modal You do not currently have access to this content.