Intermittent negative pressure applied to the lower limb increases foot macrocirculatory and microcirculatory blood flow pulsatility in people with spinal cord injury

Sundby, Øyvind Heiberg; Høiseth, Lars Øivind; Irgens, Ingebjørg; Mathiesen, Iacob; Lundgaard, Eivind; Haugland, Hanne; Weedon‐Fekjær, Harald; Sundhagen, Jon Otto; Sanbæk, Gunnar; Hisdal, Jonny

doi:10.1038/s41393-017-0049-8

Cited by 5 publications

(5 citation statements)

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“…The finding that an INP level of −40 mmHg induced acute increase in arterial blood flow and skin blood flow is in line with previous studies (Sundby et al ; Sundby et al ; ). However, the mechanisms of action leading to increased blood flow during INP are not well described in the literature.…”

Section: Discussionsupporting

confidence: 93%

“…An INP level of -10 mmHg did not significantly induce an acute increase in maximal arterial blood flow and skin blood flow compared with atmospheric pressure alone. The finding that an INP level of À40 mmHg induced acute increase in arterial blood flow and skin blood flow is in line with previous studies (Sundby et al 2016;Sundby et al 2017;2018). However, the mechanisms of action leading to increased blood flow during INP are not well described in the literature.…”

Section: Discussionsupporting

confidence: 90%

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The acute effects of different levels of intermittent negative pressure on peripheral circulation in patients with peripheral artery disease

et al. 2019

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Intermittent negative pressure (INP) applied to the lower leg induces acute increase in arterial and skin blood flow. The aim of this study was to identify the optimal level of INP to increase blood flow in patients with lower extremity peripheral artery disease (PAD). We investigated the acute effects of different levels of INP in 16 subjects (7 women and 9 men, mean (SD) age 71(8) years) diagnosed with PAD. During application of INP in a pressure chamber sealed below the knee, arterial blood flow was continuously recorded in the dorsalis pedis artery or tibialis posterior artery (ultrasound Doppler), and skin blood flow was continuously recorded at the pulp of the first toe (laser Doppler). Different pressure levels (0, −10, −20, −40, and −60 mmHg) were tested in randomized order. Maximal arterial blood flow relative to baseline (median [25th, 75th percentiles]) was: 0 mmHg; 1.08 (1.02, 1.13), −10 mmHg; 1.11 (1.07, 1.17), −20 mmHg; 1.18 (1.11, 1.32), −40 mmHg; 1.39 (1.27, 1.91) and −60 mmHg; 1.48 (1.37, 1.78). Maximal laser Doppler flux (LDF) relative to baseline was: 0 mmHg; 1.06 (1.02, 1.12), −10 mmHg; 1.08 (1.05, 1.16) −20 mmHg; 1.12 (1.06, 1.27), −40 mmHg; 1.24 (1.14, 1.50) and −60 mmHg; 1.35 (1.10, 1.70). There were significantly higher maximal arterial blood flow and maximal LDF at −40 mmHg compared with −10 mmHg (P = 0.001 and P = 0.025, respectively). There were no significant differences in maximal arterial blood flow and maximal LDF between 0 and −10 mmHg (both P = 1.0), or between −40 and −60 mmHg (both P = 1.0). INP of −40 mmHg was the lowest negative pressure level that increased blood flow.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

The acute effects of different levels of intermittent negative pressure on peripheral circulation in patients with peripheral artery disease

et al. 2019

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“…13,33,34 The main stimulus for improving vascular health may be the fluctuations in blood flow, more than increase in mean flow velocity. 12,13,15,35 The difference between the treatment groups in change in myogenic function, found in this study, may contribute to further elucidate the mechanisms of effect of INP treatment, with the possible role of arterioles.…”

Section: Discussionmentioning

confidence: 58%

The Effect of 12-Week Treatment with Intermittent Negative Pressure on Blood Flow Velocity and Flowmotion, Measured with a Novel Doppler Device (Earlybird). Secondary Outcomes from a Randomized Sham-Controlled Trial in Patients with Peripheral Arterial Disease

Pettersen

Hoel

Torp

et al. 2022

Annals of Vascular Surgery

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“…Finally, indirect support for a potential clinically relevant, beneficial effect on vascular health for these fluctuations is provided by the observation of improved wound healing upon repeated exposure to intermittent negative pressure (26,28). These observations may contribute to improved microcirculatory blood flow and therefore the delivery of oxygen and nutrients to promote wound healing (25,26). Although speculative, our findings suggest that these benefits of intermittent negative pressure stimulus on wound healing (26,28) may be related to enhanced endothelial function.…”

Section: Discussionmentioning

confidence: 65%

“…More specifically, increased antegrade and mean blood flow (velocity) was present at the onset of negative pressure, followed by marked reduction in antegrade and mean blood flow (and increase in retrograde blood flow) upon release of the negative pressure. Interestingly, frequent use of intermittent negative pressure in patients with lower-limb ischemia and ulcers is associated with improved wound healing (25,26,28). These clinical effects suggest that fluctuations in blood flow and shear stress patterns may impact vascular health in humans.…”

Section: Introductionmentioning

confidence: 99%

Fluctuation in shear rate, with unaltered mean shear rate, improves brachial artery flow-mediated dilation in healthy, young men

Holder

Dawson

Brislane

et al. 2019

Journal of Applied Physiology

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Increase in mean shear stress represents an important and potent hemodynamic stimulus to improve conduit artery endothelial function in humans. No previous study has examined whether fluctuations in shear rate patterns, without altering mean shear stress, impacts conduit artery endothelial function. This study examined the hypothesis that 30-min exposure to fluctuations in shear rate patterns, in the presence of unaltered mean shear rate, improves brachial artery flow-mediated dilation. Fifteen healthy men (27.3 ± 5.0 yr) completed the study. Bilateral brachial artery flow-mediated dilation was assessed before and after unilateral exposure to 30 min of intermittent negative pressure (10 s, −40mmHg; 7 s, 0 mmHg) to induce fluctuation in shear rate, while the contralateral arm was exposed to a resting period. Negative pressure significantly increased shear rate, followed by a decrease in shear rate upon pressure release (both P < 0.001). Across the 30-min intervention, mean shear rate was not different compared with baseline ( P = 0.458). A linear mixed model revealed a significant effect of time observed for flow-mediated dilation ( P = 0.029), with exploratory post hoc analysis showing an increase in the intervention arm (∆FMD +2.0%, P = 0.008), but not in the contralateral control arm (∆FMD +0.5%, P = 0.664). However, there was no effect for arm ( P = 0.619) or interaction effect ( P = 0.096). In conclusion, we found that fluctuations in shear patterns, with unaltered mean shear, improves brachial artery flow-mediated dilation. These novel data suggest that fluctuations in shear pattern, even in the absence of altered mean shear, represent a stimulus to acute change in endothelial function in healthy individuals. NEW & NOTEWORTHY Intermittent negative pressure applied to the forearm induced significant fluctuations in antegrade and retrograde shear rate, while mean shear was preserved relative to baseline. Our exploratory study revealed that brachial artery flow-mediated dilation was significantly improved following 30-min exposure to intermittent negative pressure. Fluctuations in blood flow or shear rate, with unaltered mean shear, may have important implications for vascular health; however, further research is required to identify the underlying mechanisms and potential long-term health benefits.

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Intermittent negative pressure applied to the lower limb increases foot macrocirculatory and microcirculatory blood flow pulsatility in people with spinal cord injury

Abstract: The Norwegian Research Council provided funding to Otivio (grant: 241589).

Cited by 5 publications

References 40 publications

The acute effects of different levels of intermittent negative pressure on peripheral circulation in patients with peripheral artery disease

The acute effects of different levels of intermittent negative pressure on peripheral circulation in patients with peripheral artery disease

The Effect of 12-Week Treatment with Intermittent Negative Pressure on Blood Flow Velocity and Flowmotion, Measured with a Novel Doppler Device (Earlybird). Secondary Outcomes from a Randomized Sham-Controlled Trial in Patients with Peripheral Arterial Disease

Fluctuation in shear rate, with unaltered mean shear rate, improves brachial artery flow-mediated dilation in healthy, young men

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