The prevention and treatment of various microcirculation disorders are one of the most important problems of medical practice. The difficulties of studying the microcirculation are related to the blood vessels small size and extensive branching within organ tissues. At present, various methods of microcirculation assessment using the laser Doppler flowmetry are applied in active clinical practice in our country. The review covers the main methods of laser Doppler flowmetry used for the diagnosis of various microcirculation disorders. The method is based on the determination of tissue blood perfusion by measuring the Doppler frequency shift while tissue is illuminated by a laser beam, followed by the registration of the reflected radiation from moving and stationary tissue components. Microcirculatory oscillation rhythm plays an important role, especially in early diagnosis of many diseases. The loss of certain types of oscillations at laser Doppler flowmetry is interpreted as «spectral narrowing» and serves as a diagnostic criterion for microcirculation deregulation, which is directly related to decreased blood perfusion and tissue hypotrophy. The use of amplitude-frequency analysis of blood flow oscillations can non-invasively evaluate the impact of the various components of microvascular tone, allowing to calculate an index of neurogenic and myogenic tone and bypass index. The amplitude-frequency analysis of the laser Doppler flowmetry spectrum uses normalized parameters determining the maximum amplitude of the blood flow oscillation in different bands, as well as their ratio - microcirculation effectiveness index. Hyperemic, spastic, spastic-atonic, structural and degenerative, congestive and stasic forms of various microcirculation disorders are marked out. Each of these microcirculatory disorders is characterized by a certain ratio of structural and functional changes and changes in blood velocity, as well as impaired barrier function. The main principles of the microcirculatory disorders are described.
The predictive value of laser Doppler fluxmetry and transcutaneous oximetry for clinical outcome in patients undergoing revascularisation for severe leg ischaemia
