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Xu C, Sellke FW, Abid MR. Assessments of microvascular function in organ systems. Am J Physiol Heart Circ Physiol 2022; 322:H891-H905. [PMID: 35333121 PMCID: PMC9037705 DOI: 10.1152/ajpheart.00589.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 01/23/2023]
Abstract
Microvascular disease plays critical roles in the dysfunction of all organ systems, and there are many methods available to assess the microvasculature. These methods can either assess the target organ directly or assess an easily accessible organ such as the skin or retina so that inferences can be extrapolated to the other systems and/or related diseases. Despite the abundance of exploratory research on some of these modalities and their possible applications, there is a general lack of clinical use. This deficiency is likely due to two main reasons: the need for standardization of protocols to establish a role in clinical practice or the lack of therapies targeted toward microvascular dysfunction. Also, there remain some questions to be answered about the coronary microvasculature, as it is complex, heterogeneous, and difficult to visualize in vivo even with advanced imaging technology. This review will discuss novel approaches that are being used to assess microvasculature health in several key organ systems, and evaluate their clinical utility and scope for further development.
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Affiliation(s)
- Cynthia Xu
- Cardiovascular Research Center, Rhode Island Hospital, Providence, Rhode Island
- Division of Cardiothoracic Surgery, Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
| | - Frank W Sellke
- Cardiovascular Research Center, Rhode Island Hospital, Providence, Rhode Island
- Division of Cardiothoracic Surgery, Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
| | - M Ruhul Abid
- Cardiovascular Research Center, Rhode Island Hospital, Providence, Rhode Island
- Division of Cardiothoracic Surgery, Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island
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Machluf Y, Rosenfeld S, Ben Shlomo I, Chaiter Y, Dekel Y. The Misattributed and Silent Causes of Poor COVID-19 Outcomes Among Pregnant Women. Front Med (Lausanne) 2021; 8:745797. [PMID: 34765620 PMCID: PMC8575767 DOI: 10.3389/fmed.2021.745797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/23/2021] [Indexed: 01/08/2023] Open
Abstract
Abundant evidence strongly suggests that the condition of pregnancy makes women and their fetuses highly vulnerable to severe Corona-virus 2019 (COVID-19) complications. Here, two novel hypoxia-related conditions are proposed to play a pivotal role in better understanding the relationship between COVID-19, pregnancy and poor health outcomes. The first condition, "misattributed dyspnea (shortness of breath)" refers to respiratory symptoms common to both advanced pregnancy and COVID-19, which are mistakenly perceived as related to the former rather than to the latter; as a result, pregnant women with this condition receive no medical attention until the disease is in an advanced stage. The second condition, "silent hypoxia", refers to abnormally low blood oxygen saturation levels in COVID-19 patients, which occur in the absence of typical respiratory distress symptoms, such as dyspnea, thereby also leading to delayed diagnosis and treatment. The delay in diagnosis and referral to treatment, due to either "misattributed dypsnea" or "silent hypoxia", may lead to rapid deterioration and poor health outcome to both the mothers and their fetuses. This is particularly valid among women during advanced stages of pregnancy as the altered respiratory features make the consequences of the disease more challenging to cope with. Studies have demonstrated the importance of monitoring blood oxygen saturation by pulse oximetry as a reliable predictor of disease severity and outcome among COVID-19 patients. We propose the use of home pulse oximetry during pregnancy as a diagnostic measure that, together with proper medical guidance, may allow early diagnosis of hypoxia and better health outcomes.
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Affiliation(s)
- Yossy Machluf
- Unit of Agrigenomics, Shamir Research Institute, Haifa University, Kazerin, Israel
| | - Sherman Rosenfeld
- The Department of Science Teaching, Weizmann Institute of Science, Rehovot, Israel
| | - Izhar Ben Shlomo
- Emergency Medicine Program, Zefat Academic College, Safed, Israel
| | - Yoram Chaiter
- The Israeli Center for Emerging Technologies in Hospitals and Hospital-Based Health Technology Assessment, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel
| | - Yaron Dekel
- Unit of Agrigenomics, Shamir Research Institute, Haifa University, Kazerin, Israel
- Department of Medical Laboratory Sciences, Zefat Academic College, Safed, Israel
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Toussaint M, Buggenhoudt L, Pelc K. Nocturnal Transcutaneous Blood Gas Measurements in a Pediatric Neurologic Population: A Quality Assessment. Dev Neurorehabil 2021; 24:303-310. [PMID: 33423573 DOI: 10.1080/17518423.2020.1869336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: To assess the quality of SpO2 and PCO2 recordings via transcutaneous monitoring in children with neurological conditions.Methods: Overnight transcutaneous SpO2 and PCO2 were analyzed. The presence of drift and drift correction was noted, and the rate of disrupted recordings scored (0: absence, 1; presence). The quality of recordings was also scored (0, 1, 2 for poor, medium, and high).Results: A total of 228 recordings from 64 children aged 9.7 ± 6 years were analyzed of which 42 used positive pressure respiratory support. The mean quality of the recordings was scored as 1.27 (0-2). PCO2 drift, drift correction, and disrupted recordings were present in 25%, 58%, and 26% of recordings, respectively. Satisfactory clinical decisions were taken in 91% of cases.Conclusion: The quality of transcutaneous sensor recordings was acceptable and clinical findings were deemed as satisfactory in the large majority of cases. Correction of PCO2 drift was challenging.
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Affiliation(s)
| | | | - Karine Pelc
- Rehabilitation Hospital Inkendaal, Vlezenbeek, Belgium
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De Braekeleer K, Toussaint M. Transcutaneous Carbon Dioxide Measurement in Adult Patients with Neuromuscular Disorders: A quality Level Assessment. J Neuromuscul Dis 2021; 8:305-313. [DOI: 10.3233/jnd-200516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Carbon dioxide tension (PCO2) monitoring during sleep, is crucial to identify respiratory failure in patients with neuromuscular disorders (NMD). Transcutaneous PCO2 monitoring is an available technique to measure PCO2. Objectives: To assess the quality level of transcutaneous blood gas measurements via SenTec monitor. Methods: A 12-month analysis of SenTec measurements was conducted in a Belgian Centre for Home Mechanical Ventilation (HMV). Over two consecutive nights; SpO2 and PCO2 measurements, the presence of PCO2 drift and drift correction with SenTec, were reviewed and scores (0, 1, 2 for poor, medium and high level) were assigned to estimate the quality of measurements. Results: Sixty-nine NMD patients met the inclusion criteria, of which 48/69 used HMV. PCO2 drift and drift correction were present in 15% and 68% of the 138 recordings, respectively. The quality level of measurements throughout night 1, scored 1.55 (0–2). The relevance of our clinical findings from SenTec scoring 1.94 (1–2); was considered highly satisfactory. HMV was ineffective in 24/48 patients. Among 12 patients with hypercapnia, 8 patients improved PCO2 between night 1 and 2. Among 12 patients with hypocapnia, PCO2 improved in 4/12 patients, who reached the range of normal PCO2 (35–47 mmHg). Conclusions: The quality of SenTec measurements was acceptable in the majority of recordings and clinical findings were deemed satisfactory in all cases. A single SenTec measurement was sufficient to determine the need for NIV. However, two SenTec registrations were insufficient to both improve NIV effectiveness in 50% of cases, and, to ensure follow-up of our interventions.
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Affiliation(s)
- Katrien De Braekeleer
- Centre for Home Mechanical Ventilation and Neuromuscular Disorders, Department of Rehabilitation, Rehabilitation Hospital Inkendaal, Vlezenbeek, Belgium
| | - Michel Toussaint
- Centre for Home Mechanical Ventilation and Neuromuscular Disorders, Department of Rehabilitation, Rehabilitation Hospital Inkendaal, Vlezenbeek, Belgium
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Quaresima V, Ferrari M. COVID-19: efficacy of prehospital pulse oximetry for early detection of silent hypoxemia. Crit Care 2020; 24:501. [PMID: 32791979 PMCID: PMC7424128 DOI: 10.1186/s13054-020-03185-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/16/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Valentina Quaresima
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy
| | - Marco Ferrari
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Via Vetoio, 67100, L'Aquila, Italy.
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van Weteringen W, Goos TG, van Essen T, Ellenberger C, Hayoz J, de Jonge RCJ, Reiss IKM, Schumacher PM. Novel transcutaneous sensor combining optical tcPO 2 and electrochemical tcPCO 2 monitoring with reflectance pulse oximetry. Med Biol Eng Comput 2020; 58:239-247. [PMID: 31741291 PMCID: PMC6994448 DOI: 10.1007/s11517-019-02067-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 11/02/2019] [Indexed: 11/18/2022]
Abstract
This study investigated the accuracy, drift, and clinical usefulness of a new optical transcutaneous oxygen tension (tcPO2) measuring technique, combined with a conventional electrochemical transcutaneous carbon dioxide (tcPCO2) measurement and reflectance pulse oximetry in the novel transcutaneous OxiVenT™ Sensor. In vitro gas studies were performed to measure accuracy and drift of tcPO2 and tcPCO2. Clinical usefulness for tcPO2 and tcPCO2 monitoring was assessed in neonates. In healthy adult volunteers, measured oxygen saturation values (SpO2) were compared with arterially sampled oxygen saturation values (SaO2) during controlled hypoxemia. In vitro correlation and agreement with gas mixtures of tcPO2 (r = 0.999, bias 3.0 mm Hg, limits of agreement - 6.6 to 4.9 mm Hg) and tcPCO2 (r = 0.999, bias 0.8 mm Hg, limits of agreement - 0.7 to 2.2 mm Hg) were excellent. In vitro drift was negligible for tcPO2 (0.30 (0.63 SD) mm Hg/24 h) and highly acceptable for tcPCO2 (- 2.53 (1.04 SD) mm Hg/12 h). Clinical use in neonates showed good usability and feasibility. SpO2-SaO2 correlation (r = 0.979) and agreement (bias 0.13%, limits of agreement - 3.95 to 4.21%) in healthy adult volunteers were excellent. The investigated combined tcPO2, tcPCO2, and SpO2 sensor with a new oxygen fluorescence quenching technique is clinically usable and provides good overall accuracy and negligible tcPO2 drift. Accurate and low-drift tcPO2 monitoring offers improved measurement validity for long-term monitoring of blood and tissue oxygenation. Graphical abstract.
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Affiliation(s)
- Willem van Weteringen
- Department of Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Tom G Goos
- Division of Neonatology, Department of Pediatrics, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Biomechanical Engineering, Faculty of Mechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Tanja van Essen
- Division of Neonatology, Department of Pediatrics, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | | | - Rogier C J de Jonge
- Division of Neonatology, Department of Pediatrics, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Pediatric Intensive Care Unit, Departments of Pediatrics and Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Irwin K M Reiss
- Division of Neonatology, Department of Pediatrics, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Rafl J, Kulhanek F, Kudrna P, Ort V, Roubik K. Response time of indirectly accessed gas exchange depends on measurement method. BIOMED ENG-BIOMED TE 2018; 63:647-655. [PMID: 28802098 DOI: 10.1515/bmt-2017-0070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 07/03/2017] [Indexed: 11/15/2022]
Abstract
Noninvasive techniques are routinely used for assessment of tissue effects of lung ventilation. However, comprehensive studies of the response time of the methods are scarce. The aim of this study was to compare the response time of noninvasive methods for monitoring of gas exchange to sudden changes in the composition of the inspired gas. A prospective experimental study with 16 healthy volunteers was conducted. A ventilation circuit was designed that enabled a fast change in the composition of the inspiratory gas mixture while allowing spontaneous breathing. The volunteers inhaled a hypoxic mixture, then a hypercapnic mixture, a hyperoxic mixture and finally a 0.3% CO mixture. The parameters with the fastest response to the sudden change of O2 in inhaled gas were peripheral capillary oxygen saturation (SpO2) and regional tissue oxygenation (rSO2). Transcutaneous oxygen partial pressure (tcpO2) had almost the same time of reaction, but its time of relaxation was 2-3 times longer. End-tidal carbon dioxide (EtCO2) response time to change of CO2 concentration in inhaled gas was less than half in comparison with transcutaneous carbon dioxide partial pressure (tcpCO2). All the examined parameters and devices reacted adequately to changes in gas concentration in the inspiratory gas mixture.
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Affiliation(s)
- Jakub Rafl
- Czech Technical University in Prague, Faculty of Biomedical Engineering, Department of Biomedical Technology, nam. Sitna 3105, 272 01 Kladno, Czech Republic, Phone: +420 728 229 991, Fax: +420 224 358 419
| | - Filip Kulhanek
- Czech Technical University in Prague, Faculty of Biomedical Engineering, Department of Biomedical Technology, 272 01 Kladno, Czech Republic
| | - Petr Kudrna
- Czech Technical University in Prague, Faculty of Biomedical Engineering, Department of Biomedical Technology, 272 01 Kladno, Czech Republic
| | - Vaclav Ort
- Czech Technical University in Prague, Faculty of Biomedical Engineering, Department of Biomedical Technology, 272 01 Kladno, Czech Republic
| | - Karel Roubik
- Czech Technical University in Prague, Faculty of Biomedical Engineering, Department of Biomedical Technology, 272 01 Kladno, Czech Republic
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Blake DF, Young DA, Brown LH. Transcutaneous oximetry: variability in normal values for the upper and lower limb. Diving Hyperb Med 2018; 48:2-9. [PMID: 29557095 DOI: 10.28920/dhm48.1.2-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 01/07/2018] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Published normal transcutaneous oxygen partial pressures (PtcO2) for the chest and lower limb have defined tissue hypoxia as a value of < 40 mmHg (< 30 mmHg in some patients, < 50 mmHg in others). AIM To determine 'normal' PtcO2 for the upper and lower limb in healthy, non-smoking adults using the Radiometer® TCM400 with tc Sensor E5250. METHOD Thirty-two volunteers had transcutaneous oxygen measurements (TCOM) performed on the chest, upper and lower limbs breathing air, with leg then arm elevated and whilst breathing 100% oxygen. RESULTS Room-air PtcO2 (mmHg, mean (95% confidence interval)) were: chest: 53.6 (48.7-58.5); upper arm: 60.0 (56.1-64.0); forearm: 52.3 (44.8-55.8); dorsum of hand: 50.2 (46.1-54.3); thenar eminence: 70.8 (67.7-73.8); hypothenar eminence: 77.9 (75.1-80.7); lateral leg: 50.2 (46.2-54.2); lateral malleolus: 50.5 (46.6-54.3); medial malleolus: 48.9 (45.6-52.1); dorsum, between first and second toe: 53.1 (49.2-57.0); dorsum, proximal to fifth toe: 58.5 (55.0 - -62.0); plantar, 1st MTP: 73.7 (70.3-77.1). Nineteen subjects had at least one room-air PtcO2 below 40 mmHg (nine upper limb, 13 lower limb, four chest). Approximately 10% lower limb PtcO2 were < 100 mmHg on normobaric oxygen. Only one subject at one site had an upper limb PtcO2 < 100 mmHg breathing oxygen. CONCLUSION The broad dispersion in PtcO2 in our healthy cohort reflects the inherent biologic variability in dermal perfusion and oxygen delivery, making it difficult to define narrow, rigid 'normal' values. Thus, we cannot recommend a single PtcO2 value as 'normal' for the upper or lower limb. A thorough patient assessment is essential to establish appropriateness for hyperbaric oxygen therapy, with TCOM used as an aid to guide this decision and not as an absolute.
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Affiliation(s)
- Denise F Blake
- Emergency Department, The Townsville Hospital, Townsville, Queensland, Australia.,Marine Biology and Aquaculture, James Cook University, Townsville.,IMB 23, Emergency Department, 100 Angus Smith Drive, The Townsville Hospital, Douglas, Queensland 4814, Australia,
| | - Derelle A Young
- Hyperbaric Medicine Unit, The Townsville Hospital, Townsville
| | - Lawrence H Brown
- Emergency Department, The Townsville Hospital, Townsville, Queensland, Australia.,Marine Biology and Aquaculture, James Cook University, Townsville
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Tissue Oxygenation and Negative-Pressure Wound Therapy When Applied to the Feet of Persons With Diabetes Mellitus: An Observational Study. J Wound Ostomy Continence Nurs 2018; 44:517-523. [PMID: 29117076 DOI: 10.1097/won.0000000000000378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Our group has reported that negative-pressure wound therapy (NPWT) decreases tissue oxygenation by 84% in the foot of diabetic patients because the pad of the connecting drainage tube and foam sponge of the NPWT system compress the wound bed. The purpose of this study was to determine whether an NPWT modified dressing application reduces tissue oxygenation in the feet of persons with diabetes mellitus. DESIGN A prospective, clinical, observational study. SUBJECTS AND SETTING We enrolled 30 patients with diabetic mellitus; their mean age was 63.9 ± 11.2 years (mean ± standard deviation). All were cared for at the diabetic wound center at an academic tertiary medical center in South Korea between 2014 and January 2015. METHODS Transcutaneous partial oxygen pressures (TcpO2) were measured to determine tissue oxygenation levels beneath modified NPWT dressings. A TcpO2 sensor was fixed at the tarsometatarsal area of the contralateral unwounded foot. A negative pressure of -125 mm Hg was applied until TcpO2 reached a plateau state; values were measured before, during, and after the modified NPWT. The Wilcoxon' and Mann-Whitney U tests were used to compare differences between these measurements. RESULTS TcpO2 levels decreased by 26% during the modified NPWT. Mean TcpO2 values before, during, and after turning off the therapy were 54.3 ± 15.3 mm Hg, 41.6 ± 16.3 mm Hg, and 53.3 ± 15.6 mm Hg (P < .05), respectively. CONCLUSION Applying NPWT without the pad of the connecting drainage tube significantly reduces the amount of tissue oxygenation loss beneath foam dressings on the skin of the foot dorsum in diabetic patients.
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Rodríguez Reyes G, Núñez Carrera L, Alessi Montero A, Solís Vivanco A, Quiñones Uriostegui I, Pérez Sanpablo AI. Effect of mechanical vibration on transcutaneous oxygen levels in the feet of type 2 diabetes mellitus patients. Med Clin (Barc) 2017; 148:16-19. [PMID: 27871769 DOI: 10.1016/j.medcli.2016.09.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 09/14/2016] [Accepted: 09/15/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVE Foot conditions in patients with diabetes mellitus (DM) are major causes of morbidity and disability. Whole body vibration may promote blood circulation in the lower limbs, hence facilitating perfusion and promoting the supply of nutrients and oxygen to comprised tissues. Transcutaneous oxygen levels (TcPO2)>40mmHg in cases of diabetic foot syndrome are associated with a good prognosis in the resolution of ulcers. The objective of this study was to determine whether whole body vibration favors some parameters of interest related to complications associated with the diabetic foot syndrome. PATIENTS AND METHODS Fifty-four patients with DM were included in a 12-week exercise program based on whole body vibration. Glycemic control was determined on the basis of the patients' levels of glycated hemoglobin (HbA1c); sensitivity and TcPO2 levels of each foot were also recorded. Assessments were performed prior to initiating the whole body vibration program and at the end of it. RESULTS No significant changes were observed in the patients' HbA1c (P=.442) levels or sensitivity (P=.07). A significant 7mmHg increase (P<.0001; effect size: d=0.53) was observed in the concentration of TcPO2. CONCLUSIONS Whole body vibration may increase TcPO2 levels with useful implications for the prevention or management of complications associated with restricted blood perfusion in the diabetic foot syndrome.
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Affiliation(s)
- Gerardo Rodríguez Reyes
- Laboratorio de Ortesis y Prótesis, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (INRLGII), Ciudad de México, México.
| | - Lidia Núñez Carrera
- Laboratorio de Análisis de Movimiento Humano, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (INRLGII), Ciudad de México, México
| | - Aldo Alessi Montero
- Laboratorio de Ingeniería de Rehabilitación, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (INRLGII), Ciudad de México, México
| | - Adriana Solís Vivanco
- Servicio de Oftalmología-Retina y Vítreo, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (INRLGII), Ciudad de México, México
| | - Ivett Quiñones Uriostegui
- Laboratorio de Análisis de Movimiento Humano, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (INRLGII), Ciudad de México, México
| | - Alberto Isaac Pérez Sanpablo
- Laboratorio de Análisis de Movimiento Humano, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra (INRLGII), Ciudad de México, México
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Yip WL. Evaluation of the clinimetrics of transcutaneous oxygen measurement and its application in wound care. Int Wound J 2014; 12:625-9. [PMID: 25196124 DOI: 10.1111/iwj.12356] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 07/22/2014] [Accepted: 07/22/2014] [Indexed: 11/26/2022] Open
Abstract
Transcutaneous oxygen (TcPO2) measurement is a non-invasive diagnostic tool increasingly being used in clinical practice. Existing evidence suggests that reduction of TcPO2 is correlated with an increase in skin ischaemia, and its measurement has been shown to have predictive value for wound healing in diabetic patients, success rate of hyperbaric oxygen therapy, amputation rate in patients suffering from peripheral vascular disease or with ischaemic ulcers. This article evaluates the clinimetrics of TcPO2 measurement in adults with discussion of its potential application in clinical practice.
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Affiliation(s)
- Wai Lam Yip
- School of Medicine, Cardiff University, Cardiff, UK.,Department of Accident and Emergency, Queen Mary Hospital, Hong Kong, Hong Kong
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