1
|
Traylor MK, Batman GB, Sears KN, Ransom KV, Hammer SM, Keller JL. Sex-specific microvascular and hemodynamic responses to passive limb heating in young adults. Microcirculation 2024; 31:e12848. [PMID: 38281244 DOI: 10.1111/micc.12848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/20/2023] [Accepted: 01/17/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE We examined sex-specific microvascular reactivity and hemodynamic responses under conditions of augmented resting blood flow induced by passive heating compared to normal blood flow. METHODS Thirty-eight adults (19 females) completed a vascular occlusion test (VOT) on two occasions preceded by rest with or without passive heating in a randomized, counterbalanced order. Skeletal muscle tissue oxygenation (StO2, %) was assessed with near-infrared spectroscopy (NIRS), and the rate of desaturation and resaturation as well as maximal StO2 (StO2max) and prolonged hypersaturation (area under the curve, StO2AUC) were quantified. Before the VOT, brachial artery blood flow (BABF), vascular conductance, and relative BABF (BABF normalized to forearm lean mass) were determined. Sex × condition ANOVAs were used. A p-value ≤.05 was considered statistically significant. RESULTS Twenty minutes of heating increased BABF compared to the control (102.9 ± 28.3 vs. 36.0 ± 20.9 mL min-1; p < .01). Males demonstrated greater BABF than females (91.9 ± 34.0 vs. 47.0 ± 19.1 mL min-1; p < .01). There was no sex difference in normalized BABF. There were no significant interactions for NIRS-VOT outcomes, but heat did increase the rate of desaturation (-0.140 ± 0.02 vs. -0.119 ± 0.03% s-1; p < .01), whereas regardless of condition, males exhibited greater rates of resaturation and StO2max than females. CONCLUSIONS These results suggest that blood flow is not the primary factor causing sex differences in NIRS-VOT outcomes.
Collapse
Affiliation(s)
- Miranda K Traylor
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, Alabama, USA
| | - Genevieve B Batman
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, Alabama, USA
| | - Kylie N Sears
- School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Kyndall V Ransom
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, Alabama, USA
- Chemistry Department, College of Arts and Science, University of South Alabama, Mobile, Alabama, USA
| | - Shane M Hammer
- School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Joshua L Keller
- Integrative Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, Alabama, USA
- Department of Physiology & Cell Biology, College of Medicine, University of South Alabama, Mobile, Alabama, USA
| |
Collapse
|
2
|
Ferrer-Uris B, Busquets A, Beslija F, Durduran T. Assessment of Microvascular Hemodynamic Adaptations in Finger Flexors of Climbers. Bioengineering (Basel) 2024; 11:401. [PMID: 38671822 PMCID: PMC11048441 DOI: 10.3390/bioengineering11040401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Climbing performance is greatly dependent on the endurance of the finger flexors which, in turn, depends on the ability to deliver and use oxygen within the muscle. Near-infrared spectroscopy (NIRS) and diffuse correlation spectroscopy (DCS) have provided new possibilities to explore these phenomena in the microvascular environment. The aim of the present study was to explore climbing-related microvascular adaptations through the comparison of the oxygen concentration and hemodynamics of the forearm between climbers and non-climber active individuals during a vascular occlusion test (VOT). Seventeen climbers and fifteen non-climbers joined the study. Through NIRS and DCS, the oxyhemoglobin (O2Hb) and deoxyhemoglobin (HHb) concentrations, tissue saturation index (TSI), and blood flow index (BFI) were obtained from the flexor digitorum profundus during the VOT. During the reactive hyperemia, climbers presented greater blood flow slopes (p = 0.043, d = 0.573), as well as greater O2Hb maximum values (p = 0.001, d = 1.263) and HHb minimum values (p = 0.009, d = 0.998), than non-climbers. The superior hemodynamics presented by climbers could indicate potential training-induced structural and functional adaptations that could enhance oxygen transportation to the muscle, and thus enhance muscle endurance and climbing performance.
Collapse
Affiliation(s)
- Blai Ferrer-Uris
- Institut Nacional d’Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), 08038 Barcelona, Spain;
| | - Albert Busquets
- Institut Nacional d’Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), 08038 Barcelona, Spain;
| | - Faruk Beslija
- ICFO-Institut de Ciències Fotòniques, Barcelona Institute of Science and Technology (BIST), 08860 Castelldefels, Spain; (F.B.); (T.D.)
| | - Turgut Durduran
- ICFO-Institut de Ciències Fotòniques, Barcelona Institute of Science and Technology (BIST), 08860 Castelldefels, Spain; (F.B.); (T.D.)
- Institució Catalana de Recerca i Estudis Avançats (ICREA), 08010 Barcelona, Spain
| |
Collapse
|
3
|
Savluk OF, Yilmaz AA, Yavuz Y, Arisut S, Ukil Isildak F, Turkmen Karaagac A, Ozbek B, Cine N, Tuncer E, Ceyran H. Assessment of microcirculatory alteration by a vascular occlusion test using near-infrared spectroscopy in pediatric cardiac surgery: effect of cardiopulmonary bypass. Expert Rev Med Devices 2024; 21:249-255. [PMID: 38217402 DOI: 10.1080/17434440.2024.2306155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/10/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES Cardiopulmonary bypass cause microcirculatory alterations. Near infrared spectroscopic measurement of tissue oxygen saturation and vascular occlusion test are novel technologies for assessing the microcirculatory function of peripheral tissue specifically in patients undergoing cardiac surgery with cardiopulmonary bypass.Our study aimed to evaluate dynamic microcirculatory function using the vascular occlusion testing during cardiac surgery in pediatric patients. METHODS 120 pediatric patients were scheduled. Children had continuous regional oxygen saturation monitoring using near infrared spectroscopy and vascular occlusion test. Vascular occlusion test was performed five times; before induction (T1), after induction (T2), then during cardiopulmonary bypass with full flow (T3), after the termination of CPB (T4) and after sternum closure (T5). RESULTS Basal value was the lowest at T3 and this value was significantly different among measurements (p < 0,01).Values for maximum and minimum tissue oxygen saturation were the lowest at T3 (83,4 and 52,9%).The occlusion slope varied significantly among measurements (p < 0,01).Reperfusion slopes were significantly different among measurements (p < 0,01) with a further progressive decrease in reperfusion slope with duration of cardiopulmonary bypass. CONCLUSION Microcirculatory function can assessed using VOT with forearm Near-infrared spectroscopy derived variables during cardiopulmonary bypass in pediatric cardiac surgery. Noninvasive assessment of microcirculatory perfusion during cardiopulmonary bypass can further help evaluate and improve circulatory support techniques. TRIAL REGISTRATION The research Project was registered at ClinicalTrials.gov (NCT06191913).
Collapse
Affiliation(s)
- Omer Faruk Savluk
- Anesthesiology and Reanimation Clinic, Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
| | - Abdullah Arif Yilmaz
- Pediatric Cardiac Surgery Clinic, Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
| | - Yasemin Yavuz
- Anesthesiology and Reanimation Clinic, Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
| | - Seda Arisut
- Anesthesiology and Reanimation Clinic, Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
| | - Fatma Ukil Isildak
- Anesthesiology and Reanimation Clinic, Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
| | - Aysu Turkmen Karaagac
- Anesthesiology and Reanimation Clinic, Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
| | - Baburhan Ozbek
- Pediatric Cardiac Surgery Clinic, Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
| | - Nihat Cine
- Pediatric Cardiac Surgery Clinic, Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
| | - Eylem Tuncer
- Pediatric Cardiac Surgery Clinic, Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
| | - Hakan Ceyran
- Pediatric Cardiac Surgery Clinic, Kartal Kosuyolu High Education and Training Hospital, Istanbul, Turkey
| |
Collapse
|
4
|
Greaves LM, Zaleski KS, Matias AA, Gyampo AO, Giuriato G, Lynch M, Lora B, Tomasi T, Basso E, Finegan E, Schickler J, Venturelli M, DeBlauw JA, Shostak E, Blum OE, Ives SJ. Limb, sex, but not acute dietary capsaicin, modulate the near-infrared spectroscopy- vascular occlusion test estimate of muscle metabolism. Physiol Rep 2024; 12:e15988. [PMID: 38537943 PMCID: PMC10972678 DOI: 10.14814/phy2.15988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 04/07/2024] Open
Abstract
The downward slope during the near-infrared spectroscopy (NIRS)-vascular occlusion test (NIRS-VOT) is purported as a simplified estimate of metabolism. Whether or not the NIRS-VOT exhibits sex- or limb-specificity or may be acutely altered remains to be elucidated. Thus, we investigated if there is limb- or sex specificity in tissue desaturation rates (DeO2) during a NIRS-VOT, and if acute dietary capsaicin may alter this estimate of muscle metabolism. Young healthy men (n = 25, 21 ± 4 years) and women (n = 20, 20 ± 1 years) ingested either placebo or capsaicin, in a counterbalanced, single-blind, crossover design after which a simplified NIRS-VOT was conducted to determine the DeO2 (%/s), as an estimate of oxidative muscle metabolism, in both the forearm (flexors) and thigh (vastus lateralis). There was a significant limb effect with the quadriceps having a greater DeO2 than the forearm (-2.31 ± 1.34 vs. -1.78 ± 1.22%/s, p = 0.007, ηp 2 = 0.19). There was a significant effect of sex on DeO2 (p = 0.005, ηp 2 = 0.203) with men exhibiting a lesser DeO2 than women (-1.73 ± 1.03 vs. -2.36 ± 1.32%/s, respectively). This manifested in significant interactions of limb*capsaicin (p = 0.001, ηp 2 = 0.26) as well as limb*capsaicin*sex on DeO2 (p = 0.013, ηp 2 = 0.16) being observed. Capsaicin does not clearly alter O2-dependent muscle metabolism, but there was apparent limb and sex specificity, interacting with capsaicin in this NIRS-derived assessment.
Collapse
Affiliation(s)
- Lauren M. Greaves
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Kendall S. Zaleski
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Alexs A. Matias
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
- Department of Kinesiology and Applied PhysiologyUniversity of DelawareNewarkDelawareUSA
| | - Abena O. Gyampo
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Gaia Giuriato
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
- Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Meaghan Lynch
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Brian Lora
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Tawn Tomasi
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Emma Basso
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Emma Finegan
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Jack Schickler
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Massimo Venturelli
- Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Justin A. DeBlauw
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Elena Shostak
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Oliver E. Blum
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| | - Stephen J. Ives
- Health and Human Physiological Sciences DepartmentSkidmore CollegeSaratoga SpringsNew YorkUSA
| |
Collapse
|
5
|
Grotowska M, Gozdzik W. Intraoperative intravenous infusion of lidocaine increases total and small vessel densities of sublingual microcirculation: a randomized prospective pilot study. J Int Med Res 2023; 51:3000605231209820. [PMID: 37940618 PMCID: PMC10637181 DOI: 10.1177/03000605231209820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
OBJECTIVE Multiple organ failure can occur as a result of postoperative complications. Research has indicated that the underlying mechanism of organ dysfunction is a microcirculation disorder. Because of its antioxidant and anti-inflammatory properties, lidocaine has the potential to improve microvascular blood flow. This study was performed to assess the effect of intraoperative intravenous lidocaine infusion on the microcirculation and determine the incidence of postoperative complications. METHODS In this prospective randomized double-blind pilot study, 12 patients scheduled for abdominal surgery were randomly allocated to receive an intraoperative infusion of either 1% lidocaine or the same volume of 0.9% sodium chloride solution. The microcirculation was monitored using sidestream dark-field imaging and the vascular occlusion test combined with near-infrared spectroscopy. RESULTS Lidocaine significantly increased the total vascular density and small vessel density after 2 hours of infusion, with preservation of 99% to 100% of the capillary perfusion in both groups. No patients developed organ failure. CONCLUSIONS An increase in vessel density may be beneficial in major abdominal surgeries because it is associated with better tissue perfusion and oxygen delivery. However, this finding requires further investigation in patients with increased surgical risk. Overall, this study indicates that lidocaine has potential to improve microvascular perfusion.Research Registry number: 9549 (https://www.researchregistry.com/browse-the-registry#home/registrationdetails/650ffd27b3f547002bd7635f/).
Collapse
Affiliation(s)
- Małgorzata Grotowska
- Clinical Department of Anesthesiology and Intensive Therapy, University Hospital in Wroclaw, Wroclaw Medical University, Wroclaw, Poland
| | - Waldemar Gozdzik
- Clinical Department of Anesthesiology and Intensive Therapy, University Hospital in Wroclaw, Wroclaw Medical University, Wroclaw, Poland
| |
Collapse
|
6
|
Cortese L, Zanoletti M, Karadeniz U, Pagliazzi M, Yaqub MA, Busch DR, Mesquida J, Durduran T. Performance Assessment of a Commercial Continuous-Wave Near-Infrared Spectroscopy Tissue Oximeter for Suitability for Use in an International, Multi-Center Clinical Trial. Sensors (Basel) 2021; 21:6957. [PMID: 34770264 DOI: 10.3390/s21216957] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/27/2021] [Accepted: 10/08/2021] [Indexed: 01/17/2023]
Abstract
Despite the wide range of clinical and research applications, the reliability of the absolute oxygenation measurements of continuous wave near-infrared spectroscopy sensors is often questioned, partially due to issues of standardization. In this study, we have compared the performances of 13 units of a continuous wave near-infrared spectroscopy device (PortaMon, Artinis Medical Systems, NL) to test their suitability for being used in the HEMOCOVID-19 clinical trial in 10 medical centers around the world. Detailed phantom and in vivo tests were employed to measure the precision and reproducibility of measurements of local blood oxygen saturation and total hemoglobin concentration under different conditions: for different devices used, different operators, for probe repositioning over the same location, and over time (hours/days/months). We have detected systematic differences between devices when measuring phantoms (inter-device variability, <4%), which were larger than the intra-device variability (<1%). This intrinsic variability is in addition to the variability during in vivo measurements on the forearm muscle resulting from errors in probe positioning and intrinsic physiological noise (<9%), which was also larger than the inter-device differences (<3%) during the same test. Lastly, we have tested the reproducibility of the protocol of the HEMOCOVID-19 clinical trial; that is, forearm muscle oxygenation monitoring during vascular occlusion tests over days. Overall, our conclusion is that these devices can be used in multi-center trials but care must be taken to characterize, follow-up, and statistically account for inter-device variability.
Collapse
|
7
|
Kaile K, Fernandez C, Godavarty A. Development of a Smartphone-Based Optical Device to Measure Hemoglobin Concentration Changes for Remote Monitoring of Wounds. Biosensors (Basel) 2021; 11:165. [PMID: 34063972 DOI: 10.3390/bios11060165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 01/13/2023]
Abstract
Telemedicine (TM) can revolutionize the impact of diabetic wound care management, along with tools for remote patient monitoring (RPM). There are no low-cost mobile RPM devices for TM technology to provide comprehensive (visual and physiological) clinical assessments. Here, a novel low-cost smartphone-based optical imaging device has been developed to provide physiological measurements of tissues in terms of hemoglobin concentration maps. The device (SmartPhone Oxygenation Tool—SPOT) constitutes an add-on optical module, a smartphone, and a custom app to automate data acquisition while syncing a multi-wavelength near-infrared light-emitting diode (LED) light source (690, 810, 830 nm). The optimal imaging conditions of the SPOT device were determined from signal-to-noise maps. A standard vascular occlusion test was performed in three control subjects to observe changes in hemoglobin concentration maps between rest, occlusion, and release time points on the dorsal of the hand. Hemoglobin concentration maps were compared with and without applying an image de-noising algorithm, single value decomposition. Statistical analysis demonstrated that the hemoglobin concentrations changed significantly across the three-time stamps. Ongoing efforts are in imaging diabetic foot ulcers using the SPOT device to assess its potential as a smart health device for physiological monitoring of wounds remotely.
Collapse
|
8
|
Butler E, Chin M, Aneman A. Peripheral Near-Infrared Spectroscopy: Methodologic Aspects and a Systematic Review in Post-Cardiac Surgical Patients. J Cardiothorac Vasc Anesth 2016; 31:1407-1416. [PMID: 27876185 DOI: 10.1053/j.jvca.2016.07.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Ethan Butler
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Melissa Chin
- Intensive Care Unit, Liverpool Hospital, Sydney, Australia
| | - Anders Aneman
- Intensive Care Unit, Liverpool Hospital, Sydney, Australia; University of New South Wales, South Western Sydney Clinical School, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia.
| |
Collapse
|