Effects of temperature on blood circulation measured with the laser doppler method

Song, Chang W.; Chelstrom, Lisa M.; Levitt, Seymour H.; Haumschild, Daniel J.

doi:10.1016/0360-3016(89)90153-3

Cited by 58 publications

(21 citation statements)

References 22 publications

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“…It is estimated that an increase in normal skin temperature from 32°C to 40°C results in a 10- to 15-fold increase in cutaneous blood flow as demonstrated by laser Doppler [6] and that a 3°C increase in body temperature elevates the peak fentanyl plasma concentration by 25% [7]. Another study showed that heating the patch during the first four hours after application increased the maximum plasma concentration almost three fold [8].…”

Section: Discussionmentioning

confidence: 99%

Life-threatening coma and full-thickness sunburn in a patient treated with transdermal fentanyl patches: a case report

et al. 2012

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IntroductionFentanyl transdermal patches have been widely used in the treatment of chronic pain and in palliative care settings since 1991 in cases where prolonged opioid use is often necessary. Transdermal drug delivery is deemed safe and effective with the advantages of delivering a steady dose of the drug and improving patient compliance due to its ease of use. However, intentional and unintentional misuse and overdose using transdermal opioid patches has been widely reported in the literature.Case presentationWe describe the case of a 77-year-old Caucasian woman who developed severe opioid toxicity while sun tanning, likely due to altered fentanyl transdermal patch function in a heated environment. As a result of prolonged sun exposure due to an opioid-induced coma she then sustained hyperthermia and severe burns to her abdomen and lower limbs. This inadvertent fentanyl overdose necessitated initial treatment in intensive care and follow on care in a specialist burn unit.ConclusionPatients who are using fentanyl patches and their relatives should be educated about how to use the patch safely. Healthcare practitioners should warn patients about the possibility of overdosing on transdermally delivered drugs if used incorrectly. They should avoid strenuous activities and external heat sources such as warming blankets, hot water bottles, saunas, hot tubs or sunbathing and should seek medical attention if they develop a fever. Additionally, any burns sustained in the context of altered consciousness levels such as in this case with opioid overdose should raise suspicion about a potential deeper burn injury than is usually observed.

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Section: Discussionmentioning

confidence: 99%

Life-threatening coma and full-thickness sunburn in a patient treated with transdermal fentanyl patches: a case report

et al. 2012

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“…The stable interrelations between velocity and concentration in LDPM‐0·25 and LDPM‐0·14 indicate parallel changes of the two factors in this experimental set‐up. Under other conditions divergent responses can be seen (Song et al ., 1989).…”

Section: Discussionmentioning

confidence: 99%

“…This instrument allows differentiation between average velocity and concentration of the blood cells generating the Doppler signal. Distinguishing between average velocity and concentration has been shown to be beneficial for interpreting observed changes in microvascular blood flow (Svensson & Jönsson, 1987; Song et al ., 1989; Rendell et al ., 1992). Furthermore, we used a probe with two detecting fibres separated by 0·25 and 0·14 mm from the illuminating fibre, corresponding to a deep and superficial measure, respectively (Jakobsson & Nilsson, 1993).…”

Section: Introductionmentioning

confidence: 99%

Sympathetic skin vasoconstriction – further evaluation using laser Doppler techniques

Holmlund

Freccero

Bornmyr

et al. 2001

Clinical Physiology

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The aim of this study was to quantify the reflex sympathetic vasoconstriction in skin at different depths. Twenty healthy subjects were studied. Finger skin blood flow was measured using laser Doppler perfusion imaging (LDPI) and laser Doppler perfusion monitoring (LDPM). In LDPM, a probe with fibres separated 0.25 mm (deep) and 0.14 mm (superficial) from the illuminating fibre was used. Local heating (40 degrees C) was achieved with a Peltier element, and reflex vasoconstriction induced by immersion of the contra-lateral hand and forearm for 3 min in water at 15 degrees C. The change in skin blood flow was measured and a vasoconstriction index (VAC: cooling/before cooling) calculated. VAC indices of LDPI, LDPM-0.25 and LDPM-0.14 were 0.60, 0.59 and 0.60, respectively. The two components of the LDPM perfusion value, blood cell velocity and concentration, were studied separately. Their contributions in LDPM-0.25 were roughly the same, whereas the velocity component dominated in LDPM-0.14, although their relative responses in the two channels were similar. We conclude that sympathetic skin vasoconstriction does not significantly differ in two compartments, as probed with fibres separated by 0.25 and 0.14 mm. Blood cell velocity is influenced in a proportional way, as is concentration.

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“…Other sources of external heat such as warming blankets [66,67], sauna [71,72], hot tubs [68] or even hot weather [74,77] and fever [54] have been reported to cause overdoses from transdermal patches. Because elevated plasma concentrations are frequently observed after local heating, enhanced cutaneous blood flow is assumed to be the dominant cause for increased drug absorption [65,[69][70][71][72]78,79]. Additionally, diffusion, which is the main mechanism of transdermal drug delivery, as a temperature-dependent process might be fastened with elevated skin and/or patch temperature [78].…”

Section: Applicationmentioning

confidence: 99%

A systematic review of medication administration errors with transdermal patches

Lampert

Seiberth

Haefeli³

et al. 2014

Expert Opinion on Drug Safety

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The systematic investigation of published errors illustrated that every step in the transdermal patch administration process is prone to errors. Thereby, the lack of knowledge and awareness of the importance of a correct administration practice were a major source of risk. Based on the identified errors and causes of errors prevention strategies were developed as a first step in avoiding transdermal patch administration errors.

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Effects of temperature on blood circulation measured with the laser doppler method

Cited by 58 publications

References 22 publications

Life-threatening coma and full-thickness sunburn in a patient treated with transdermal fentanyl patches: a case report

Life-threatening coma and full-thickness sunburn in a patient treated with transdermal fentanyl patches: a case report

Sympathetic skin vasoconstriction – further evaluation using laser Doppler techniques

A systematic review of medication administration errors with transdermal patches

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