scholarly journals Μελέτη της τοπικής εγκεφαλικής αιματικής ροής με τη μέθοδο της Thermal Doppler Flowmetry και συσχέτιση των τιμών της με το κυτταρικό μικροπεριβάλλον (μέσω των τιμών της εγκεφαλικής μικροδιάλυσης) σε υπαραχνοειδή αιμορραγία

2017 ◽  
Author(s):  
Δημήτριος Παπαδόπουλος
Keyword(s):  
Brain Microdialysis ◽  
Microdialysis Catheter ◽  
Doppler Flowmetry ◽  
Codman Microsensor

Εισαγωγή. Η παρακολούθηση της εγκεφαλικής μικροδιάλυσης επιτρέπει την αξιολόγηση της τοπικής εγκεφαλικής μεταβολικής φυσιολογίας και παρέχει βιοδείκτες σε κρίσιμες καταστάσεις, όπως η υπαραχνοειδής αιμορραγία (ΥΑΑ).Σκοπός Ο σκοπός της παρούσας μελέτης ήταν να διερευνηθεί η συσχέτιση μεταξύ της περιοχικής αιματικής εγκεφαλικής ροής και των παραμέτρων της μικροδιάλυσης (οι συγκεντρώσεις γλυκόζης, γαλακτικού, γλυκερόλης και πυροσταφυλικού και η μεταβολική αναλογία γαλακτικού/πυροσταφυλικού) σε ασθενείς με υπαραχνοειδή αιμορραγία.Μεθοδολογία Eίκοσι ένα ασθενείς με υπαραχνοειδή αιμορραγία συμπεριλήφθησαν στην παρούσα προοπτική μελέτη.Εισήχθη ένα ελάχιστα επεμβατικό, πολυπαραμετρικό σύστημα νευροπαρακολούθησης κατά τις πρώτες 8 ώρες μετά την εισαγωγή στη ΜΕΘ.Έγινε κρανιοανάτρηση στο μετωπιαίο οστό, στο σημείο Kocher υπό άσηπτες συνθήκες όπου τοποθετήθηκε ένα τρικαναλικό bolt kit που χρησιμοποιήθηκε για την εισαγωγή: (α) ενός καθετήρα μέτρησης ενδοκράνιας πίεσης (ICP) (Codman microsensor kit, Codman, Johnson & Johnson, Raynham. ΜΑ, USA), (β) ενός καθετήρα μέτρησης οξυγόνου του εγκεφαλικού ιστού (PbrO2 catheter, Licox, Integra Neurosciences. Plainsboro. NJ. USA) και (γ) ενός καθετήρα εγκεφαλικής μικροδιάλυσης (CMA 70 Brain Microdialysis Catheter, 10 mm membrane length, 20 kDa cut off, CMA. Stockholm, Sweden).Έγινε δεύτερη κρανιοανάτρηση, 1-1.5 cm πρόσθια από την προηγούμενη (προς αποφυγή επιμόλυνσης των δύο πεδίων), για την εισαγωγή καθετήρα μέτρησης της εγκεφαλικής αιματικής ροής (CBF) (Hemedex, Bowman. Boston, MA, USA). Καταγράφηκαν οι μετρήσεις της εγκεφαλικής αιματικής ροής (βασιζόμενη στη μεθοδολογία της θερμικής διάχυσης), ο θερμικός συντελεστής Κ και η μικροδιάλυση των εγκεφαλικών βιοχημικών δεικτών. Όλοι οι ασθενείς υποβλήθηκαν σε θεραπεία με πρωτόκολλο κατευθυνόμενο από την πίεση εγκεφαλικής αιμάτωσης (CPP).Η διάρκεια της παρακολούθησης του εγκεφάλου και καταγραφής των τιμών ήταν 10 ημέρες.Αποτελέσματα•Η εγκεφαλική θερμοκρασία βρέθηκε να είναι υψηλότερη στους επιζώντες (36,83 oC έναντι 36,48 oC στους μη επιζώντες).•Η CBF παρατηρήθηκε υψηλότερη στους επιζώντες (33,66 έναντι 29,34 ml/ 100gr/min στους μη επιζώντες).•Οι τιμές του γαλακτικού οξέος βρέθηκαν να είναι υψηλότερες στους επιζώντες (8,52 mmol/L έναντι 5,89 mmol/L για τους επιζώντες και μη επιζώντες αντίστοιχα).•Η γλυκόζη, γλυκερόλη και πυροσταφυλικό βρέθηκαν σε υψηλότερες τιμές στους μη επιζώντες σε σύγκριση με τους επιζώντες (1,18 mmol/L αντί 0,99 mmol/L, 122,92 μmol/L έναντι 92,29 μmol/L και 124,47 μmol/L αντί 112,06 μmol/L, αντίστοιχα).•Οι μη επιζώντες είχαν αυξημένο το λόγο L/Ρ και το συντελεστή Κ σε σύγκριση με τους επιζώντες (L/P: 50,01 ± 24,79 αντί 39,36 ± 9,57, K: 3,34 ± 0,69 αντί 3,02 ± 0,35, αντίστοιχα). Οι διαφορές δεν έφθασαν το επίπεδο στατιστικής σημαντικότητας (p>0,10).•Όσον αφορά τις συσχετίσεις των παραμέτρων της μικροδιάλυσης με τη CBF, την Κ, και την Τ, αλλά και μεταξύ τους, οι συσχετίσεις διαφοροποιούνται ανάλογα με το επίπεδο της CBF.Στο σύνολο του δείγματος: •Ο συντελεστής Κ συσχετίστηκε θετικά με τη CBF, την Τ, τη γλυκόζη και αρνητικά με το πυρουβικό (GEE) (p<0,05).•Η αναλογία L/P συσχετίστηκε θετικά με τη γλυκερόλη και αρνητικά με τη CBF (p<0,001).ΣυμπεράσματαΟι βιοχημικοί δείκτες κυτταρικού στρες και θανάτου (γλυκερόλη, L/P) σχετίζονται θετικά μεταξύ τους. Οι τιμές Κ δεν θα πρέπει να θεωρούνται ως σταθερές όπως πιστευόταν παλαιότερα, ιδιαίτερα σε ασθενείς σε κρίσιμη κατάσταση. Ο συντελεστής Κ μπορεί να μεταβάλλεται καθώς εξελίσσεται η εγκεφαλική βλάβη και αλλάζουν οι ιδιότητες των ιστών. Οι ιατροί οφείλουν να είναι γνώστες της πολύπλοκης σχέσης μεταξύ του συντελεστή Κ και των μετρήσεων της CBF για την ακριβή ερμηνεία όλων των παραμέτρων νευροπαρακολούθησης, και κατά συνέπεια, της διαχείρισης των ασθενών

The response of skin perfusion and of rheological and immunological variables to intravenous prostanoid administration in Raynaud’s phenomenon secondary to collagenosis

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 243-249 ◽  
Author(s):  
Drinda ◽  
Neumann ◽  
Pöhlmann ◽  
Vogelsang ◽  
Stein ◽  
...  
Keyword(s):  
Laser Doppler Flowmetry ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Plasma Viscosity ◽  
Laser Doppler ◽  
Erythrocyte Aggregation ◽  
Control Group ◽  
Long Term Effects ◽  
Doppler Flowmetry

Background: Prostanoids are used in the treatment of Raynaud’s phenomenon and acral perfusion disorders secondary to collagenosis. In subjective terms, intravenous administration of these agents produces success in more than 50% of patients. The therapeutic outcome of clinical administration of alprostadil or iloprost may vary from individual to individual. Patients and methods: The following variables were analysed in a cross-over study in 27 patients with collagenosis and Raynaud’s phenomenon: plasma viscosity and erythrocyte aggregation (rheological variables), partial pressure of oxygen and laser Doppler flowmetry in the finger region, and lymphocyte phenotyping and interleukin (IL) determinations (immunological variables). Results: Laser Doppler flowmetry revealed significant differences between patients with secondary Raynaud’s phenomenon and a control group of 25 healthy subjects. Laser Doppler readings did not change significantly as a result of the treatments. Therapy with iloprost produced a reduction in IL-1beta, L-selectin (CD 62 L) and IL-6. Conclusion: The change in immunological variables due to iloprost may explain the long-term effects of prostaglandins in the treatment of Raynaud’s phenomenon. From our results it is not possible to infer any preference for iloprost or alprostadil.

Microcirculation disorders in patients with vibration disease and comorbidity

2020 ◽  
pp. 672-672
Author(s):  
A. N. Kuks ◽  
N. V. Slivnitsyna
Keyword(s):  
Type 2 Diabetes ◽  
Laser Doppler Flowmetry ◽  
Laser Doppler ◽  
Combined Effects ◽  
Doppler Flowmetry ◽  
Vibration Disease ◽  
History Of

The results of laser Doppler flowmetry in patients with vibration disease associated with the combined effects of local and general vibration with a history of type 2 diabetes are presented.

Peculiarities of microcirculation in periodont tissues in children of key age groups sufficient type 1 diabetes. Part II

2019 ◽  
Vol 24 (2) ◽  
pp. 108-119 ◽  
Author(s):  
B. N. Davydov ◽  
D. A. Domenyuk ◽  
S. V. Dmitrienko
Keyword(s):  
Diabetes Mellitus ◽  
Blood Flow ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Laser Doppler Flowmetry ◽  
Laser Doppler ◽  
Diabetic Microangiopathy ◽  
Healthy Children ◽  
Doppler Flowmetry

Relevance. Morpho-functional changes in peripheral circulation established in type 1 diabetes mellitus correlate with changes in central hemodynamics, allowing the use of microcirculation indicators as diagnostic and prognostic criteria for assessing the degree of functional vascular disorders. Identifcation of microcirculation features of the blood by the method of laser Doppler flowmetry in children with different experience of type 1 diabetes in key age categories.Materials and methods. The study included 67 children with type 1 diabetes mellitus aged 12-15 years with an experience of the disease from six months to ten years. The comparison group consisted of 38 healthy children. The state of the microvasculature was assessed by laser Doppler flowmetry using a laser analyzer for capillary blood flow LAKK-OP.Results. In children with an experience of type 1 diabetes of less than two years, microcirculation disorders in periodontal tissues correspond to the hyperemic form, accompanied by increased perfusion, a decrease in the amplitude of low-frequency oscillations, increased heart rate, high blood flling, and blood flow bypass. For children with an endocrinopathy experience of more than three years, microcirculation disorders correspond to a stagnant form, combined with a decrease in perfusion due to stagnation of blood in the venular link, endothelial domination with suppression of neurogenic and cardiac fluctuations, low efciency and redistribution of blood flow in favor of the nutritive link.Conclusions. With the increase in experience, the degree of compensation of type 1 diabetes, the progression of diabetic microangiopathy, it is advisable to designate two stages of development of microcirculatory disorders. Early – compensatory with active adaptation, including neurogenic and endothelial regulation mechanisms. Late – decompensation with passive adaptation, supporting the effectiveness of microcirculation due to myogenic control of regulation, shunting and increasing the rate of blood outflow.

Laser doppler flowmetry in assessing the effectiveness of treatment of chronic demodex blefaritis

2017 ◽  
Vol 10 (2) ◽  
pp. 62-66 ◽  
Author(s):  
T.N. Safonova ◽  
◽  
N.P. Kintyukhina ◽  
V.V. Sidorov ◽  
O.V. Gladkova ◽  
...  
Keyword(s):  
Laser Doppler Flowmetry ◽  
Laser Doppler ◽  
Doppler Flowmetry

Use of human fetal liver cells for treatment of patients with lower limb peripheral artery disease

2014 ◽  
Vol 2 (1) ◽  
pp. 10-13
Author(s):  
R. Salyutin ◽  
D. Dombrowski ◽  
M. Komarov ◽  
N. Sokolov ◽  
S. Palyanitsya ◽  
...  
Keyword(s):  
Progenitor Cells ◽  
Lower Limb ◽  
Fetal Liver ◽  
Life Quality ◽  
Liver Cells ◽  
Surgical Reconstruction ◽  
Clinical Effects ◽  
Doppler Flowmetry ◽  
Human Fetal Liver ◽  
Fetal Liver Cells

In the group of patients (n = 21, mean age 54 ± 5.8 years) with chronic lower limb ischemia stage IIB who were non-liable for reconstructiverestoration surgery, we have established positive clinical effects of local transplantation of human fetal liver progenitor cells. Complex examination following 1, 3, 6 and 12 months after transplantation included duplex scanning of limb arteries, x-ray contrast arteriography and laser Doppler flowmetry as well as measuring pain-free walking and evaluating life quality based on individual questionnaire data.Owing to the transplant “Cryopreserved human fetal liver progenitor cells” the patients demonstrated stable increase of life quality index and pain-free walking as well as improvement of general health allowing assign them to the group of patients with lower ischemia stage,  quicker social rehabilitation and lesser risk of disabling surgery (р < 0.05). Also, there were observations of improved microcirculation in the ischemic extremities owing to activation of endothelium-independent mechanisms of vasodilatation, reduced myotonus and neurotonus of the pre-capillaries and improved endothelium-dependent influence on the microhaemodynamic and, hence, an increased reserve capillary blood flow (p < 0.05).Analysis of the obtained results indicates prospects and effectiveness of using fetal liver cells transplantation in the patients who are not liable for surgical reconstruction of the vascular bed.

scholarly journals Mechanisms of Venoarteriolar Reflex in Type 2 Diabetes with or without Peripheral Neuropathy

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 333
Author(s):  
Cécile Reynès ◽  
Antonia Perez-Martin ◽  
Houda Ennaifer ◽  
Henrique Silva ◽  
Yannick Knapp ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Spectral Power ◽  
Blood Perfusion ◽  
Doppler Flowmetry ◽  
Relative Contribution ◽  
Total Spectral Power ◽  
Underlying Mechanisms ◽  
Endothelial Nitric Oxide

The aim of this study is to investigate the underlying mechanisms of the venoarteriolar reflex (VAR) in type 2 diabetes mellitus (T2DM), with and without peripheral neuropathy. Laser Doppler flowmetry (LDF) recordings were performed on the medial malleus and dorsal foot skin, before and during leg dependency in healthy controls, in persons with obesity, in those with T2DM, in those with T2DM and subclinical neuropathy, and in those with T2DM and confirmed neuropathy. LDF recordings were analyzed with the wavelet transform to evaluate the mechanisms controlling the flowmotion (i.e., endothelial nitric oxide-independent and -dependent, neurogenic, myogenic, respiratory and cardiac mechanisms). Skin blood perfusion decreased throughout leg dependency at both sites. The decrease was blunted in persons with confirmed neuropathy compared to those with T2DM alone and the controls. During leg dependency, total spectral power increased in all groups compared to rest. The relative contribution of the endothelial bands increased and of the myogenic band decreased, without differences between groups. Neurogenic contribution decreased in controls, in persons with obesity and in those with T2DM, whereas it increased in subclinical- and confirmed neuropathy. In conclusion, this study provides evidence that confirmed diabetic neuropathy alters the VAR through the neurogenic response to leg dependency.

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.

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