scholarly journals Low-pressure sequential compression of lower limbs enhances forearm skin blood flow

2016 ◽  
Vol 39 (6) ◽  
pp. 204 ◽  
Author(s):  
Guy Amah ◽  
Sebastian Voicu ◽  
Philippe Bonnin ◽  
Nathalie Kubis
Keyword(s):  
Blood Flow ◽  
Skin Blood Flow ◽  
Cardiac Cycle ◽  
Low Pressure ◽  
Lower Limbs ◽  
Test Results ◽  
Skin Microcirculation ◽  
Doppler Flowmetry ◽  
Non Invasive ◽  
Forearm Skin

Purpose: We investigated whether forearm skin blood flow could be improved when a multilayer pulsatile inflatable suit was applied at a low pressure to the lower limbs and abdomen. We hypothesized that a non-invasive purely mechanical stimulation of the lower limbs could induce remote forearm blood flow modifications. Methods: The pulsatile suit induced a sequential compartmentalized low compression (65 mmHg), which was synchronized with each diastole of the cardiac cycle with each phase evolving centripetally (lower limbs to abdomen). Modifications of the forearm skin blood flow were continuously recorded by laser Doppler flowmetry (LDF) at baseline and during the pulsatile suit application. Endothelium-dependent and endothelium-independent vasodilations of the forearm skin microcirculation were measured by LDF in response to a local transdermal iontophoretic application of acetylcholine (ACh-test) and to hyperthermia (hyperT- test). Results: Twenty-four healthy volunteers, 12 men and 12 women (43±14 years) were included in the study. LDF responses increased 1) under pulsatile suit (97±106%, p

Reflex Sympathetic Dystrophy: Result of Autonomic Denervation?

1994 ◽  
Vol 87 (6) ◽  
pp. 663-669 ◽  
Author(s):  
H. A. J. M. Kurvers ◽  
M. J. H. M. Jacobs ◽  
R. J. Beuk ◽  
F. A. J. M. Van den Wildenberg ◽  
P. J. E. H. M. Kitslaar ◽  
...  
Keyword(s):  
Blood Flow ◽  
Skin Blood Flow ◽  
Reflex Sympathetic Dystrophy ◽  
Stage I ◽  
Sympathetic Denervation ◽  
Stage Iii ◽  
Cold Sensation ◽  
Skin Microcirculation ◽  
Doppler Flowmetry ◽  
Sympathetic Dysfunction

1. To investigate the nature of sympathetic dysfunction in the pathogenesis of reflex sympathetic dystrophy, the microcirculatory vasoconstrictive responses to dependency were investigated in the skin of the hand of 76 reflex sympathetic dystrophy patients with unilateral disease by means of laser Doppler flowmetry (in perfusion units) and capillary microscopy. The patients were divided into three stages according to their perception of skin temperature (stage I in the case of a stationary warmth sensation, stage II in the case of an intermittent warmth and cold sensation, and stage III in the case of a stationary cold sensation). The vasoconstrictive responses were induced by lowering of the affected hand. 2. As compared to controls, the mainly sympathetically mediated vasoconstrictive response at thermoregulatory level of the skin microcirculation, as measured by laser Doppler flowmetry, was attenuated at stage I (1.82 versus 1.41, P < 0.05), stage II (1.82 versus 1.09, P < 0.0001) and stage III (1.82 versus 1.14, P < 0.01), suggesting the involvement of sympathetic denervation at all stages of the reflex sympathetic dystrophy syndrome. This sympathetic denervation may also account for the observed increase in thermoregulatory skin blood flow at stage I as compared to controls (152 versus 81, P < 0.01). 3. Since sympathetic denervation has been reported to cause increased sensitivity of vascular structures to catecholamines, the decrease in thermoregulatory skin blood flow at stages II (54 versus 81, P < 0.05) and III (31 versus 81, P < 0.05), both as compared to controls, may result from hypersensitivity to catecholamines of skin microvessels. 4. The sympathetically independent vasoconstrictive response at the nutritive level of skin microcirculation, as measured by capillary microscopy, was impaired only at stage III as compared to controls (1.04 versus 2.06, P < 0.05). This divergence in microvascular reactivity upon dependency of the nutritive and thermoregulatory subsystems also supports the hypothesis of sympathetic dysfunction. 5. The disturbed vasoconstrictive responses to dependency may give rise to raised capillary pressures, contributing to the formation of oedema. 6. These findings suggest that sympathetic denervation and consequent hypersensitivity to catecholamines play an important role in the pathophysiology of reflex sympathetic dystrophy.

Vasoactive properties of lignocaine administered by iontophoresis in human skin

2003 ◽  
Vol 104 (1) ◽  
pp. 87-92 ◽  
Author(s):  
David J. NEWTON ◽  
Alexandra K.B. AMYES ◽  
Faisel KHAN ◽  
Graeme A. MCLEOD ◽  
Jonathan BANNISTER ◽  
...  
Keyword(s):  
Blood Flow ◽  
Skin Blood Flow ◽  
Doppler Imaging ◽  
Invasive Technique ◽  
Young Males ◽  
Non Invasive ◽  
Forearm Skin ◽  
The Difference ◽  
Iontophoretic Delivery ◽  
Positively Charged

The vasoactivity of lignocaine has an important influence on its clinical efficacy and systemic vascular absorption. The aim of this study was to evaluate its vasoactive properties when administered by the non-invasive technique of iontophoresis. We used laser Doppler imaging to measure the forearm skin blood flow responses of seven healthy young males to iontophoretic delivery of two preparations of 20g/l of lignocaine hydrochloride, one containing the preservatives methylparaben and propylparaben and one without. The subjects were blind to the order of drug administration, and we assessed analgesia at the sites using a pinprick test. Delivery of both preparations of (positively charged) lignocaine under the anode caused demonstrable analgesia, but no change in skin blood flow. An increase in perfusion was measured, however, when the preservative-containing preparation was administered under the cathode. There was little or no response to the solution without preservatives, although the difference in response between the two preparations was not statistically significant (P = 0.063). Although there were no vasoactive effects of lignocaine at the relatively low dose used in the present study, our results suggest that the preservatives methylparaben and propylparaben are the most likely cause of the vasodilatation that we observed under the cathode, and may therefore have a significant influence on the vasoactivity of this preparation when administered by injection. Both are negatively charged in solution and have been reported to possess vasodilator properties. It might be worth considering the use of alternative, non-vasoactive preservatives in local anaesthetic preparations, or avoiding the use of additives altogether, when this is feasible.

The influence of topical capsaicin on the local thermal control of skin blood flow in humans

2001 ◽  
Vol 281 (3) ◽  
pp. R894-R901 ◽  
Author(s):  
Dan P. Stephens ◽  
Nisha Charkoudian ◽  
Jessica M. Benevento ◽  
John M. Johnson ◽  
Jean Louis Saumet
Keyword(s):  
Blood Flow ◽  
Skin Blood Flow ◽  
Thermal Sensation ◽  
Thermal Control ◽  
Heating Unit ◽  
Local Skin ◽  
Doppler Flowmetry ◽  
Forearm Skin ◽  
Local Warming ◽  
Topical Capsaicin

To test whether heat-sensitive receptors participate in the cutaneous vascular responses to direct heating, we monitored skin blood flow (SkBF; laser Doppler flowmetry) where the sensation of heat was induced either by local warming (TLoc; Peltier cooling/heating unit) or by both direct warming and chemical stimulation of heat-sensitive nociceptors (capsaicin). In part I, topical capsaicin (0.075 or 0.025%) was applied to 12 cm2 of skin 1 h before stepwise local warming of untreated and capsaicin-treated forearm skin. Pretreatment with 0.075% capsaicin cream shifted the SkBF/TLoc relationship to lower temperatures by an average of 6 ± 0.8°C ( P < 0.05). In part II, we used a combination of topical capsaicin (0.025%) and local warming to evoke thermal sensation at one site and only local warming to evoke thermal sensation at a separate site. Cutaneous vasomotor responses were compared when the temperatures at these two sites were perceived to be the same. SkBF differed significantly between capsaicin and control sites when compared on the basis of actual temperatures, but that difference became insignificant when compared on the basis of the perceived temperatures. These data suggest heat-sensitive nociceptors are important in the cutaneous vasodilator response to local skin warming.

scholarly journals Responses in Skin Microcirculation to Vestibular Stimulation Before and During Motion Sickness

1997 ◽  
Vol 24 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Ognyan I. Kolev ◽  
Claes Möller ◽  
Gert Nilsson ◽  
Lita Tibbling
Keyword(s):  
Blood Flow ◽  
Motion Sickness ◽  
Skin Blood Flow ◽  
Vertical Axis ◽  
Vestibular Stimulation ◽  
Laser Doppler ◽  
Skin Microcirculation ◽  
Doppler Flowmetry ◽  
The Difference ◽  
Axis Rotation

ABSTRACT:Background:Observation of physiological changes during motion sickness is required to quantify the degree of sickness. The review of the literature does not show unifying results. An objective symptom of motion sickness is facial pallor. It reflects changes in skin microcirculation which have not been measured so far.Methods:Eleven healthy volunteers susceptible to motion sickness were subjected to eccentric vertical axis rotation. The dynamics and the correspondence of the changes in skin blood flow in two segments, forehead and finger, were measured by laser Doppler flowmeter.Results and Conclusions:The difference in the microcirculatory skin blood flow across the phases of motion sickness is significant for the forehead but not for the fingertip; the established dynamics of the forehead blood flow during motion sickness will be of benefit in quantifying the degree of sickness; there is no correlation between the blood flow changes in both measured areas; the rhythmic blood flow fluctuation increases during motion sickness; there is a difference between the blood flow responses to vestibular stimulation before the appearance of motion sickness and in the course of the sickness. Laser Doppler flowmetry is a reliable method in quantifying the degree of motion sickness.

Using reactive hyperemia to investigate the effect of cupping sizes of cupping therapy on skin blood flow responses

2021 ◽  
pp. 1-7
Author(s):  
Xiangfeng He ◽  
Xueyan Zhang ◽  
Fuyuan Liao ◽  
Li He ◽  
Xin Xu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Laser Doppler Flowmetry ◽  
Skin Blood Flow ◽  
Repeated Measures ◽  
Recovery Time ◽  
Reactive Hyperemia ◽  
Cupping Therapy ◽  
Doppler Flowmetry ◽  
Healthy Participants ◽  
Hyperemic Response

BACKGROUND: Various cupping sizes of cupping therapy have been used in managing musculoskeletal conditions; however, the effect of cupping sizes on skin blood flow (SBF) responses is largely unknown. OBJECTIVE: The objective of this study was to compare the effect of three cupping sizes of cupping therapy on SBF responses. METHODS: Laser Doppler flowmetry (LDF) was used to measure SBF on the triceps in 12 healthy participants in this repeated measures study. Three cup sizes (35, 40 and 45 mm in diameter) were blinded to the participants and were tested at -300 mmHg for 5 minutes. Reactive hyperemic response to cupping therapy was expressed as a ratio of baseline SBF. RESULTS: All three sizes of cupping cups resulted in a significant increase in peak SBF (p< 0.001). Peak SBF of the 45 mm cup (9.41 ± 1.32 times) was significantly higher than the 35 mm cup (5.62 ± 1.42 times, p< 0.05). Total SBF of the 45 mm cup ((24.33 ± 8.72) × 103 times) was significantly higher than the 35 mm cup ((8.05 ± 1.63) × 103 times, p< 0.05). Recovery time of the 45 mm cup (287.46 ± 39.54 seconds) was significantly longer than the 35 mm cup (180.12 ± 1.42 seconds, p< 0.05). CONCLUSIONS: Our results show that all three cup sizes can significantly increase SBF. The 45 mm cup is more effective in increasing SBF compared to the 35 mm cup.

scholarly journals Minimal role for H1 and H2 histamine receptors in cutaneous thermal hyperemia to local heating in humans

2006 ◽  
Vol 100 (2) ◽  
pp. 535-540 ◽  
Author(s):  
Brett J. Wong ◽  
Sarah J. Williams ◽  
Christopher T. Minson
Keyword(s):  
Blood Flow ◽  
Receptor Antagonist ◽  
Skin Blood Flow ◽  
Local Heating ◽  
Histamine Receptor ◽  
Receptor Activation ◽  
Control Site ◽  
Doppler Flowmetry ◽  
Histamine Receptor Antagonist ◽  
And Control

The precise mechanism(s) underlying the thermal hyperemic response to local heating of human skin are not fully understood. The purpose of this study was to investigate a potential role for H1 and H2 histamine-receptor activation in this response. Two groups of six subjects participated in two separate protocols and were instrumented with three microdialysis fibers on the ventral forearm. In both protocols, sites were randomly assigned to receive one of three treatments. In protocol 1, sites received 1) 500 μM pyrilamine maleate (H1-receptor antagonist), 2) 10 mM l-NAME to inhibit nitric oxide synthase, and 3) 500 μM pyrilamine with 10 mM NG-nitro-l-arginine methyl ester (l-NAME). In protocol 2, sites received 1) 2 mM cimetidine (H2 antagonist), 2) 10 mM l-NAME, and 3) 2 mM cimetidine with 10 mM l-NAME. A fourth site served as a control site (no microdialysis fiber). Skin sites were locally heated from a baseline of 33 to 42°C at a rate of 0.5°C/5 s, and skin blood flow was monitored using laser-Doppler flowmetry (LDF). Cutaneous vascular conductance was calculated as LDF/mean arterial pressure. To normalize skin blood flow to maximal vasodilation, microdialysis sites were perfused with 28 mM sodium nitroprusside, and control sites were heated to 43°C. In both H1 and H2 antagonist studies, no differences in initial peak or secondary plateau phase were observed between control and histamine-receptor antagonist only sites or between l-NAME and l-NAME with histamine receptor antagonist. There were no differences in nadir response between l-NAME and l-NAME with histamine-receptor antagonist. However, the nadir response in H1 antagonist sites was significantly reduced compared with control sites, but there was no effect of H2 antagonist on the nadir response. These data suggest only a modest role for H1-receptor activation in the cutaneous response to local heating as evidenced by a diminished nadir response and no role for H2-receptor activation.

Skin blood flow responses during sleep by laser Doppler flowmetry

1999 ◽  
Vol 53 (2) ◽  
pp. 117-119 ◽  
Author(s):  
Yasufumi Shiihara ◽  
Akihisa Hirota ◽  
Yosinari Kobayashi ◽  
Toshiyuki Nakamiya ◽  
Masahisa Kodama
Keyword(s):  
Blood Flow ◽  
Laser Doppler Flowmetry ◽  
Skin Blood Flow ◽  
Laser Doppler ◽  
Doppler Flowmetry

Synchronous and baroceptor-sensitive oscillations in skin microcirculation: evidence for central autonomic control

1997 ◽  
Vol 273 (4) ◽  
pp. H1867-H1878 ◽  
Author(s):  
Luciano Bernardi ◽  
Daniel Hayoz ◽  
René Wenzel ◽  
Claudio Passino ◽  
Alessandro Calciati ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Skin Blood Flow ◽  
Muscle Sympathetic Nerve Activity ◽  
Low Frequency ◽  
Doppler Flowmetry ◽  
Sympathetic Modulation ◽  
Baroreflex Stimulation ◽  
The Relationship ◽  
Spontaneous Fluctuations

To determine whether skin blood flow is local or takes part in general regulatory mechanisms, we recorded laser-Doppler flowmetry (LDF; left and right index fingers), blood pressure, muscle sympathetic nerve activity (MSNA), R-R interval, and respiration in 10 healthy volunteers and 3 subjects after sympathectomy. We evaluated 1) the synchronism of LDF fluctuations in two index fingers, 2) the relationship with autonomically mediated fluctuations in other signals, and 3) the LDF ability to respond to arterial baroreflex stimulation (by neck suction at frequencies from 0.02 to 0.20 Hz), using spectral analysis (autoregressive uni- and bivariate, time-variant algorithms). Synchronous LDF fluctuations were observed in the index fingers of healthy subjects but not in sympathectomized patients. LDF fluctuations were coherent with those obtained for blood pressure, MSNA, and R-R interval. LDF fluctuations were leading blood pressure in the low-frequency (LF; 0.1 Hz) band and lagging in the respiratory, high-frequency (HF; ∼0.25 Hz) band, suggesting passive “downstream” transmission only for HF and “upstream” transmission for LF from the microvessels. LDF fluctuations were responsive to sinusoidal neck suction up to 0.1 Hz, indicating response to sympathetic modulation. Skin blood flow thus reflects modifications determined by autonomic activity, detectable by frequency analysis of spontaneous fluctuations.

scholarly journals P1161CUTANEOUS MICROCIRCULATORY DYSFUNCTION IN PERITONEAL DIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Jennifer Williams ◽  
Mark Gilchrist ◽  
Donald Fraser ◽  
David Strain ◽  
Angela Shore
Keyword(s):  
Peritoneal Dialysis ◽  
Statistical Significance ◽  
Microvascular Function ◽  
Healthy Controls ◽  
Dialysis Patients ◽  
Skin Microcirculation ◽  
Doppler Flowmetry ◽  
Microvascular Reactivity ◽  
Co Morbidity ◽  
Forearm Skin

Abstract Background and Aims Microvascular impairment is an early step in cardiovascular disease (CVD), the major cause of morbidity and mortality in patients with CKD. Changes in skin microvascular reactivity have been shown to reflect more widespread changes in the systemic and coronary microcirculation. Microvascular function is attenuated by advancing age and conditions that commonly coexist with CKD such as diabetes and hypertension. We investigated whether skin microvascular reactivity is impaired in peritoneal dialysis (PD) patients compared with healthy controls and whether this impairment is independent of comorbidity. Method Forearm skin vasculature was examined in 27 healthy controls, 27 patients on PD and 27 controls matched to the PD patients for age, gender, diabetes and previous CV events. Microvascular function was assessed using laser Doppler flowmetry in combination with post-occlusive reactive hyperaemia (a test of generalised microvascular function) and iontophoretic application of acetylcholine (ACh) and sodium nitroprusside (SNP) to investigate endothelium dependant and non-endothelium dependant vasodilation respectively. Results Peak post-occlusive flow was lower in the PD patients than in both the healthy controls and the co-morbidity matched group; 90.45 AU (60.9-128.35) in healthy controls, 73AU (58.8-134.4) in matched controls and 56.95AU (45.1-89.8) in PD patients (p=0.0239 healthy controls versus patients, p=0.0373 matched controls versus patients). SNP-mediated vasodilatation was statistically lower in the PD group compared with healthy controls (p= 0.016), ACh response was lower but did not reach statistical significance (p= 0.076). ACh and SNP-mediated vasodilatation trended towards being lower in PD patients than matched controls but did not reach statistical significance. Conclusion The PD patients were characterised by a generalised dysfunction of the skin microcirculation compared with healthy controls and controls matched for factors known to affect the microcirculation. This appears to be the result of impaired endothelium dependant and independent vasodilatory mechanisms.

Interactions between local and reflex influences on human forearm skin blood flow

1976 ◽  
Vol 41 (6) ◽  
pp. 826-831 ◽  
Author(s):  
J. M. Johnson ◽  
G. L. Brengelmann ◽  
L. B. Rowell
Keyword(s):  
Blood Flow ◽  
Skin Blood Flow ◽  
Forearm Blood Flow ◽  
Lower Body Negative Pressure ◽  
Muscle Blood Flow ◽  
Whole Body ◽  
Vasoconstrictor Response ◽  
Human Forearm ◽  
Forearm Skin ◽  
Forearm Muscle

A three-part experiment was designed to examine interactions between local and reflex influences on forearm skin blood flow (SkBF). In part I locally increasing arm skin temperature (Tsk) to 42.5 degrees C was not associated with increases in underlying forearm muscle blood flow, esophageal temperature (Tes), or forearm blood flow in the contralateral cool arm. In part II whole-body Tsk was held at 38 or 40 degrees C and the surface temperature of one arm held at 38 or 42 degrees C for prolonged periods. SkBF in the heated arm rose rapidly with the elevation in body Tsk and arm Tsk continued to rise as Tes rose. SkBF in the arm kept at 32 degrees C paralleled rising Tes. In six studies, SkBF in the cool arm ultimately converged with SkBF in the heated arm. In eight other studies, heated arm SkBF maintained an offset above cool arm SkBF throughout the period of whole-body heating. In part III, local arm Tsk of 42.5 degrees C did not abolish skin vasoconstrictor response to lower body negative pressure. We conclude that local and reflex influences to skin interact so as to modify the degree but not the pattern of skin vasomotor response.

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