Regulation of oxygen consumption by vasomotion

Multimodal Device and Computer Algorithm-Based Monitoring of Pancreatic Microcirculation Profiles In Vivo

OBJECTIVES

Pancreatic microcirculation has an essential role in orchestrating pancreatic homeostasis. Inherent complexity and technological limitation lead to interobserver variability and 1-sided microcirculatory data. Here, we introduce a multimodal device and computer algorithm-based platform for monitoring and visualizing integrated pancreatic microcirculation profiles.

METHODS

After anesthetizing and exposing pancreas tissue of BALB/c mice, probes of Oxygen to See, Microx TX3, and MoorVMS-LDF2 were positioned at pancreas in situ to capture the pancreatic microcirculatory oxygen (hemoglobin oxygen saturation, relative amount of hemoglobin, and partial oxygen pressure) and microhemodynamic data (microvascular blood perfusion and velocity). To assess and visualize pancreatic microcirculation profiles, raw data of pancreatic microcirculation profiles were processed and transformed using interquartile range and min-max normalization by Python and Apache ECharts.

RESULTS

The multimodal device-based platform was established and 3-dimensional microcirculatory modules were constructed. Raw data sets of pancreatic microcirculatory oxygen and microhemodynamic were collected. The outlier of data set was adjusted to the boundary value and raw data set was preprocessed. Normalized pancreatic microcirculation profiles were integrated into the 3-dimensional histogram and scatter modules, respectively. The 3-dimensional modules of pancreatic microcirculation profiles were then generated.

CONCLUSIONS

We established a multimodal device and computer algorithm-based monitoring platform for visualizing integrated pancreatic microcirculation profiles.

Race-specific differences in the phase coherence between blood flow and oxygenation: A simultaneous NIRS, white light spectroscopy and LDF study

Race-specific differences in the level of glycated hemoglobin are well known. However, these differences were detected by invasive measurement of mean oxygenation, and their understanding remains far from complete. Given that oxygen is delivered to the cells by hemoglobin through the cardiovascular system, a possible approach is to investigate the phase coherence between blood flow and oxygen transportation. Here we introduce a noninvasive optical method based on simultaneous recordings using NIRS, white light spectroscopy and LDF, combined with wavelet-based phase coherence analysis. Signals were recorded simultaneously for individuals in two groups of healthy subjects, 16 from Sub-Saharan Africa (BA group) and 16 Europeans (CA group). It was found that the power of myogenic oscillations in oxygenated and de-oxygenated hemoglobin is higher in the BA group, but that the phase coherence between blood flow and oxygen saturation, or blood flow and hemoglobin concentrations is higher in the CA group.

Effect of continuous compression and 30:2 cardiopulmonary resuscitation on cerebral microcirculation in a porcine model of cardiac arrest

BACKGROUND

The effect of rescue breathing on neurologic prognosis after cardiopulmonary resuscitation (CPR) is controversial. Therefore, we investigated the cerebral microcirculatory and oxygen metabolism during continuous compression (CC) and 30:2 CPR (VC) in a porcine model of cardiac arrest to determine which is better for neurologic prognosis after CPR.

METHODS

After 4 min of ventricular fibrillation, 20 pigs were randomised into two groups (n=10/group) receiving CC-CPR or VC-CPR. Cerebral oxygen metabolism and blood flow were measured continuously using laser Doppler flowmetry. Haemodynamic data were recorded at baseline and 5 min, 30 min, 2 h and 4 h after restoration of spontaneous circulation (ROSC).

RESULTS

Compared with the VC group, the mean cortical cerebral blood flow was significantly higher at 5 min ROSC in the CC group (P<0.05), but the difference disappeared after that time point. Brain percutaneous oxygen partial pressures were higher, and brain percutaneous carbon dioxide partial pressures were lower, in the VC group from 30 min to 4 h after ROSC; significant differences were found between the two groups (P<0.05). However, no significant difference of the cerebral oxygen extraction fraction existed between the two groups.

CONCLUSIONS

Inconsistency of systemic circulation and cerebral microcirculation with regard to blood perfusion and oxygen metabolism is common after CPR. No significant differences in cortical blood flow and oxygen metabolism were found between the CC-CPR and VC-CPR groups after ROSC.

Measurements and modeling of transient blood flow perturbations induced by brief somatosensory stimulation

Proper interpretation of BOLD fMRI and other common functional imaging methods requires an understanding of neurovascular coupling. We used laser speckle-contrast optical imaging to measure blood-flow responses in rat somatosensory cortex elicited by brief (2 s) forepaw stimulation. Results show a large increase in local blood flow speed followed by an undershoot and possible late-time oscillations. The blood flow measurements were modeled using the impulse response of a simple linear network, a four-element windkessel. This model yielded excellent fits to the detailed time courses of activated regions. The four-element windkessel model thus provides a simple explanation and interpretation of the transient blood-flow response, both its initial peak and its late-time behavior.

An association between vasomotion and oxygen extraction

Vasomotion is defined as a spontaneous local oscillation in vascular tone whose function is unclear but may have a beneficial effect on tissue oxygenation. Optical reflectance spectroscopy and laser Doppler fluximetry provide unique insights into the possible mechanisms of vasomotion in the cutaneous microcirculation through the simultaneous measurement of changes in concentration of oxyhemoglobin ([HbO(2)]), deoxyhemoglobin ([Hb]), and mean blood saturation (S(mb)O(2)) along with blood volume and flux. The effect of vasomotion at frequencies <0.02 Hz attributed to endothelial activity was studied in the dorsal forearm skin of 24 healthy males. Fourier analysis identified periodic fluctuations in S(mb)O(2) in 19 out of 24 subjects, predominantly where skin temperatures were >29.3°C (X(2) = 6.19, P < 0.02). A consistent minimum threshold in S(mb)O(2) (mean: 39.4%, range: 24.0-50.6%) was seen to precede a sudden transient surge in flux, inducing a fast rise in S(mb)O(2). The integral increase in flux correlated with the integral increase in [HbO(2)] (Pearson's correlation r(2) = 0.50, P < 0.001) and with little change in blood volume suggests vasodilation upstream, responding to a low S(mb)O(2) downstream. This transient surge in flux was followed by a sustained period where blood volume and flux remained relatively constant and a steady decrease in [HbO(2)] and equal and opposite increase in [Hb] was considered to provide a measure of oxygen extraction. A measure of this oxygen extraction has been approximated by the mean half-life of the decay in S(mb)O(2) during this period. A comparison of the mean half-life in the 8 normal subjects [body mass index (BMI) <26.0 kg/m(2)] of 12.2 s and the 11 obese subjects (BMI >29.5 kg/m(2)) of 18.8 s was statistically significant (Mann Whitney, P < 0.004). The S(mb)O(2) fluctuated spontaneously in this saw tooth manner by an average of 9.0% (range 4.0-16.2%) from mean S(mb)O(2) values ranging from 30 to 52%. These observations support the hypothesis that red blood cells may act as sensors of local tissue hypoxia, through the oxygenation status of the hemoglobin, and initiate improved local perfusion to the tissue through hypoxic vasodilation.

Informational dynamics of vasomotion in microvascular networks: a review

Vasomotion refers to spontaneous oscillation of small vessels observed in many microvascular beds. It is an intrinsic phenomenon unrelated to cardiac rhythm or neural and hormonal regulation. Vasomotion is found to be particularly prominent under conditions of metabolic stress. In spite of a significant existent literature on vasomotion, its physiological and pathophysiological roles are not clear. It is thought that modulation of vasomotion by vasoactive substances released by metabolizing tissue plays a role in ensuring optimal delivery of nutrients to the tissue. Vasomotion rhythms exhibit a great variety of temporal patterns from regular oscillations to chaos. The nature of vasomotion rhythm is believed to be significant to its function, with chaotic vasomotion offering several physiological advantages over regular, periodic vasomotion. In this article, we emphasize that vasomotion is best understood as a network phenomenon. When there is a local metabolic demand in tissue, an ideal vascular response should extend beyond local microvasculature, with coordinated changes over multiple vascular segments. Mechanisms of information transfer over a vessel network have been discussed in the literature. The microvascular system may be regarded as a network of dynamic elements, interacting, either over the vascular anatomical network via gap junctions, or physiologically by exchange of vasoactive substances. Drawing analogies with spatiotemporal patterns in neuronal networks of central nervous system, we ask if properties like synchronization/desynchronization of vasomotors have special significance to microcirculation. Thus the contemporary literature throws up a novel view of microcirculation as a network that exhibits complex, spatiotemporal and informational dynamics.

Stochasticity of flow through microcirculation as a regulator of oxygen delivery

OBJECTIVE

Observations of microcirculation reveal that the blood flow is subject to interruptions and resumptions. Accepting that blood randomly stops and resumes, one can show that the randomness could be a powerful means to match oxygen delivery with oxygen demand.

METHOD

The ability of the randomness to regulate oxygen delivery is based on two suppositions: (a) the probability for flow to stop does not depend on the time of uninterrupted flow, thus the number of interruptions of flow follows a Poisson distribution; (b) the probability to resume the flow does not depend on the time for flow being interrupted; meaning that time spent by erythrocytes at rest follows an exponential distribution. Thus the distribution of the time to pass an organ is a compound Poisson distribution. The Laplace transform of the given distribution gives the fraction of oxygen that passes the organ.

RESULT

Oxygen delivery to the tissues directly depends on characteristics of the irregularity of the flow through microcirculation.

CONCLUSION

By variation of vasomotion activity it is possible to change delivery of oxygen to a tissue by up to 8 times.

A model for transient oxygen delivery in cerebral cortex

Popular hemodynamic brain imaging methods, such as blood oxygen-level dependent functional magnetic resonance imaging (BOLD fMRI), would benefit from a detailed understanding of the mechanisms by which oxygen is delivered to the cortex in response to brief periods of neural activity. Tissue oxygen responses in visual cortex following brief visual stimulation exhibit rich dynamics, including an early decrease in oxygen concentration, a subsequent large increase in concentration, and substantial late-time oscillations (“ringing”). We introduce a model that explains the full time-course of these observations made by Thompson et al. (2003). The model treats oxygen transport with a set of differential equations that include a combination of flow and diffusion in a three-compartment (intravascular, extravascular, and intracellular) system. Blood flow in this system is modeled using the impulse response of a lumped linear system that includes an inertive element; this provides a simple biophysical mechanism for the ringing. The model system is solved numerically to produce excellent fits to measurements of tissue oxygen. The results give insight into the dynamics of cerebral oxygen transfer, and can serve as the starting point to understand BOLD fMRI measurements.

Is mean blood saturation a useful marker of tissue oxygenation?

Increasingly we are monitoring the distribution of oxygen through the microcirculation using optical techniques such as optical reflectance spectroscopy (ORS) and near-infrared spectroscopy. Mean blood oxygen saturation (SmbO2) and tissue oxygenation index measured by these two techniques, respectively, evoke a concept of the measurement of oxygen delivery to tissue. This study aims to establish whether SmbO2 is an appropriate indicator of tissue oxygenation. Spontaneous fluctuations in SmbO2 observed as changes in concentration of oxyhemoglobin ([HbO2]) and deoxyhemoglobin ([Hb]) were measured by ORS in the skin microcirculation of 30 healthy subjects (15 men, age 21–42 yr). Fourier analysis identified two distinctly different spontaneous falls in SmbO2. The first type of swing, thought to be induced by fluctuations in arterial blood volume, resulted from the effects of respiration, endothelial, sympathetic, and myogenic activity. There was no apparent change in [Hb]. In contrast, a second type of swing resulted from a fall in [HbO2] accompanied by a rise in [Hb] and was only induced by endothelial and sympathetic activity. Thus the same fall in SmbO2 can be induced by two distinct responses. A “type I” swing does not suggest an inadequacy in oxygen delivery whereas a “type II” swing may indicate a change in oxygen delivery from blood to tissue. SmbO2 alone cannot therefore be accepted as a definitive marker of tissue oxygenation.

Intermittent capillary perfusion in rat pancreas grafts following short- and long-term preservation in University of Wisconsin solution

In pancreas transplantation (PTx), ischemia/reperfusion-induced deterioration of graft-microcirculation is accompanied by alterations of intermittent capillary perfusion (IP; alternating cessation and resumption of capillary blood flow) is known to counteract malperfusion. Incidence and effectiveness of IP following short- versus long-term preservation of pancreas grafts with University of Wisconsin (UW) solution has not been examined so far. PTx was performed in Lewis rats following 2-h or 18-h preservation in UW solution. Using intravital fluorescence microscopy, functional capillary density (FCD), red blood cell (RBC) velocity, IP-incidence and -frequency were analyzed. Laser Doppler flowmetry allowed for the determination of erythrocyte flux and velocity. Measurements were performed at 30, 60 and 120 min after reperfusion. Nontransplanted animals served as controls. FCD, RBC-velocity and -flux remained unchanged in the 2-h group. IP was encountered in 87% of all observation areas at 120 min. After 18-h ischemia, FCD was significantly reduced, which was paralleled by a 50% incidence of IP at 120 min. Tissue edema and leukocyte infiltration in pancreas grafts following 18-h preservation were significantly enhanced. Therefore, IP is an important mechanism aimed at improving microcirculation and UW solution is suitable to preserve vasomotion-activities enabling long-term preservation in a pancreas graft.