scholarly journals WALANT–Epinephrine injection may lead to short term, reversible episodes of critical oxygen saturation in the fingertips

2021 ◽  
Vol 141 (3) ◽  
pp. 527-533
Author(s):  
P. Moog ◽  
M. Dozan ◽  
J. Betzl ◽  
I. Sukhova ◽  
H. Kükrek ◽  
...  
Keyword(s):  
Blood Flow ◽  
Oxygen Saturation ◽  
Substantial Reduction ◽  
Tissue Perfusion ◽  
Critical Levels ◽  
Short Term ◽  
Doppler Flowmetry ◽  
Epinephrine Injection ◽  
Venous Oxygen Saturation

Abstract Introduction Although the WALANT technique’s long-term safeness has been demonstrated in many studies, there are only few data investigating its short-term effects on tissue perfusion and oxygen levels. It was hypothesized that, temporarily, critical levels of tissue perfusion may occur. Methods Seventeen patients, who were scheduled for different procedures in WALANT technique, were injected with 5–7 ml of 1% Articain containing 1:200,000 epinephrine at the finger base. Capillary-venous oxygen saturation, hemoglobin volume in the capillaries, and relative blood flow in the fingertips were recorded once per second by white light spectrometry and laser Doppler flowmetry before, during and after injection for an average of 32 min. Results Clinically, no persistent tissue malperfusion was observed, and there were no postoperative complications. Capillary-venous oxygen saturation was reduced by ≥ 30% in seven patients. Critical levels of oxygen saturation were detected in four patients during 13 intervals, each lasting for 132.5 s on average. Oxygen saturation returned to noncritical values in all patients by the end of the observation period. Blood flow in the fingertips was reduced by more than 30% in nine patients, but no critical levels were observed, as with the hemoglobin. Three patients demonstrated a reactive increase in blood flow of more than 30% after injection. Conclusions Injection of tumescent local anesthesia containing epinephrine into finger base may temporarily cause a substantial reduction in blood flow and lead to critical levels of oxygen saturation in the fingertips. However, this was fully reversible within minutes and does not cause long-term complications.

Fiber-optic transmission catheter for regional venous oxygen saturation and blood flow

1992 ◽  
Vol 72 (4) ◽  
pp. 1616-1621 ◽  
Author(s):  
H. Iwasaki ◽  
K. Yoshizaki ◽  
H. Koyano
Keyword(s):  
Blood Flow ◽  
Oxygen Saturation ◽  
Fiber Optics ◽  
Fiber Optic ◽  
Supply And Demand ◽  
Flow Measurements ◽  
Face To Face ◽  
Flexible Polymer ◽  
Venous Oxygen Saturation ◽  
The Face

We have developed a method for monitoring regional venous oxygen saturation. The key feature of this system is the use of highly flexible polymer fiber optics, and this flexibility allowed the production of a new fiber-optic transmission catheter. The space between the “face-to-face” positioned fiber-optic tips forms a remote catheter-based transmission cell. Our method applies Twersky's theory, in which absorption and scattering can be treated independently. Fresh rabbit blood was pumped through a disk oxygenator in which gas exchange occurred and passed the catheter. Simultaneous results obtained by the catheter and a cuvette oximeter were excellent (r = 0.99, SD = 1.1%). Oxygen saturation measured by this catheter was independent of vessel wall artifacts, blood pH, and flow velocity. Another application of this method is measurement of blood flow by the dye- (indocyanine green) dilution technique. The results of flow measurements by the catheter appeared to be satisfactory (r = 0.99, SD = 1.7%). This study concludes that our method is effective for monitoring the balance between regional oxygen supply and demand.

Skeletal Blood Flow in Paget's Disease of Bone and its Response to Calcitonin Therapy

1978 ◽  
Vol 54 (1) ◽  
pp. 69-74 ◽  
Author(s):  
R. Wootton ◽  
J. Reeve ◽  
E. Spellacy ◽  
M. Tellez-Yudilevich
Keyword(s):  
Alkaline Phosphatase ◽  
Blood Flow ◽  
Serum Alkaline Phosphatase ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Short Term ◽  
Urinary Hydroxyproline ◽  
Rapid Fall ◽  
Hydroxyproline Excretion

1. Blood flow to the skeleton was measured by the 18F clearance method of Wootton, Reeve & Veall (1976) in 24 patients with untreated Paget's disease. In every patient but one, resting skeletal blood flow was increased. There was a significant positive correlation between skeletal blood flow and serum alkaline phosphatase and between skeletal blood flow and urinary total hydroxyproline excretion. 2. Fourteen patients were re-studied after they had received short-term (7 days or less) or long-term (7 weeks or more) calcitonin. Skeletal blood flow, alkaline phosphatase and urinary hydroxyproline excretion fell towards normal in every case. There was some evidence from the short-term studies that calcitonin produced a more rapid fall in skeletal blood flow than in alkaline phosphatase. 3. Glomerular filtration rate appeared to increase transiently in response to calcitonin.

scholarly journals Brain oxygen saturation assessment in neonates using T2-prepared blood imaging of oxygen saturation and near-infrared spectroscopy

2016 ◽  
Vol 37 (3) ◽  
pp. 902-913 ◽  
Author(s):  
Thomas Alderliesten ◽  
Jill B De Vis ◽  
Petra MA Lemmers ◽  
Jeroen Hendrikse ◽  
Floris Groenendaal ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Infrared Spectroscopy ◽  
Magnetic Resonance ◽  
Oxygen Saturation ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Sagittal Sinus ◽  
Venous Oxygen Saturation ◽  
Blood Imaging

Although near-infrared spectroscopy is increasingly being used to monitor cerebral oxygenation in neonates, it has a limited penetration depth. The T2-prepared Blood Imaging of Oxygen Saturation (T2-BIOS) magnetic resonance sequence provides an oxygen saturation estimate on a voxel-by-voxel basis, without needing a respiratory calibration experiment. In 15 neonates, oxygen saturation measured by T2-prepared blood imaging of oxygen saturation and near-infrared spectroscopy were compared. In addition, these measures were compared to cerebral blood flow and venous oxygen saturation in the sagittal sinus. A strong linear relation was found between the oxygen saturation measured by magnetic resonance imaging and the oxygen saturation measured by near-infrared spectroscopy ( R2 = 0.64, p < 0.001). Strong linear correlations were found between near-infrared spectroscopy oxygen saturation, and magnetic resonance imaging measures of frontal cerebral blood flow, whole brain cerebral blood flow and venous oxygen saturation in the sagittal sinus ( R2 = 0.71, 0.50, 0.65; p < 0.01). The oxygen saturation obtained by T2-prepared blood imaging of oxygen saturation correlated with venous oxygen saturation in the sagittal sinus ( R2 = 0.49, p = 0.023), but no significant correlations could be demonstrated with frontal and whole brain cerebral blood flow. These results suggest that measuring oxygen saturation by T2-prepared blood imaging of oxygen saturation is feasible, even in neonates. Strong correlations between the various methods work as a cross validation for near-infrared spectroscopy and T2-prepared blood imaging of oxygen saturation, confirming the validity of using of these techniques for determining cerebral oxygenation.

scholarly journals Research of adaptation mechanisms of regulation of microcirculatory beds in patients with hemophilia

2019 ◽  
Vol 6 (3) ◽  
pp. 54-58
Author(s):  
I. L. Davydkin ◽  
Yu. A. Gergel ◽  
D. A. Kudlay ◽  
I. V. Kurtov ◽  
E. O. Danilova ◽  
...  
Keyword(s):  
Vascular Tone ◽  
Tissue Perfusion ◽  
Severe Form ◽  
Stress Factor ◽  
Control Group ◽  
Short Term ◽  
Doppler Flowmetry ◽  
Cardiovascular Pathology ◽  
Adaptation Mechanisms

Introduction. Frequent bleeding with hemophilia significantly worsens the quality of life of patients. The pathogenesis of hemorrhage in hemophilia has not been studied enough, especially at the vascular level, so it is necessary to study microcirculation in this disease. The purpose of the study is to assess the mechanisms of regulation of blood tissue perfusion and the adaptive reserves of the microcirculation system in patients with hemophilia. Materials and methods. Total microcirculation was assessed by laser Doppler flowmetry in 44 patients with hemophilia A between the ages of 14 and 20 years. Severe form of the disease was in 59 % of patients, the average – in 32 %, light – in 9 % of patients. The control group included 26 healthy men aged 14 to 19 years. The sensors recorded blood flow in the index fingers on both sides. In 20 patients with hemophilia А, an occlusion test was performed. The results of the study. In patients with hemophilia, asymmetric changes in microcirculation parameters were detected when measured in the area of the index fingers. At rest in patients with hemophilia, the prevalence of vasospasm was revealed: a decrease in the perfusion index M, an increased blood bypass due to the predominance of myogenic tone. However, neurogenic tone indicators tended to decrease. During occlusive ischemia, vasospasm is slowed down in the first seconds after the onset of exposure to the stress factor. Conclusion. The study revealed a dysregulation of the vascular tone of the microvasculature in young hemophilia patients at rest and under the influence of a stress factor in the form of short-term ischemia. Therefore, with hemophilia from a young age, control of microcirculation is necessary for the timely prevention of both bleeding and cardiovascular pathology associated with vasospasm.

A new technique to map vulva microcirculation using laser Doppler perfusion imager

2003 ◽  
Vol 13 (6) ◽  
pp. 812-818
Author(s):  
J. Saravanamuthu ◽  
A. M. Seifalian ◽  
W. M. Reid ◽  
A. B. Maclean
Keyword(s):  
Blood Flow ◽  
Skin Blood Flow ◽  
Lichen Sclerosus ◽  
Tissue Perfusion ◽  
Laser Doppler ◽  
The Novel ◽  
Doppler Flowmetry ◽  
Uninvolved Skin ◽  
A New Technique ◽  
First Time

The location of the vulva has had limited technologic progress in the assessment of the skin microcirculation and its application to clinical practice. Our group previously demonstrated increased perfusion in vulvar cancer compared to adjacent uninvolved skin with the laser Doppler flowmetry (LDF). The LDF is severely limited by its low spatial resolution (∼1 mm2) and pressure involved in positioning of the probe, which may affect value of the underlying tissue perfusion. Topographic perfusion mapping of the whole vulvar skin using LDF is also time consuming and is not clinically practical. We describe for the first time the application of the novel laser Doppler perfusion imager (LDPI) to map vulvar skin blood flow and give example in two cases with well-defined vulvar pathology—psoriasis and lichen sclerosus with invasive neoplasia—and discuss the potential of LDPI to study vulvar skin blood flow.

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