Laser Doppler velocimetry in critically ill patients

Waxman, Kenneth; FORMOSA, PAULA; Soliman, Hani; Tominaga, Gail T.; Police, Alice; Hyatt, John A.

doi:10.1097/00003246-198708000-00015

Cited by 15 publications

(2 citation statements)

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“…One objection may be that only skin blood flow is monitored by this technique. However, it has been suggested that monitoring of skin capillary blood flow may provide useful information related to total and organ body perfusion [20]and thus may be helpful when monitoring the critically ill [21,22].…”

Section: Resultsmentioning

confidence: 99%

Circulatory effects of the PDE‐inhibitors piroximone and enoximone

Boldt¹,

Knothe²,

Zickmann³

et al. 1993

Brit J Clinical Pharma

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The isolated circulatory response to intravenous application of the phosphodiesterase (PDE) inhibitors piroximone and enoximone was studied. In a randomized sequence of 30 male patients undergoing elective aortocoronary bypass grafting either piroximone (0.5 mg kg−1; n = 10) or enoximone (0.5 mg kg−1; n = 10) were given during steady state of cardiopulmonary bypass (CPB). A group in which NaCl was given as a placebo served as a control (n = 10). MAP was reduced by piroximone (maximum −23 mm Hg) and enoximone (maximum — 18 mm Hg), whereas it increased in the control (+20 mm Hg). Volume of the extracorporeal circuit indicating venous pooling decreased more pronouncedly in the enoximone patients (–440 ml) than in the piroximone group (–300 ml). Laser Doppler flows (LDFs) increased in both PDE‐III inhibitor groups with the higher and longer increase in the enoximone‐treated patients (LDF‐forehead maximum +44%, LDF‐forearm maximum +33%). Piroximone‐induced increase in both LDFs was less pronounced with respect to both time and degree (LDF‐forehead maximum +30%, LDF‐forearm +12%). Oxygen consumption (VO2) was significantly higher in the PDE‐III inhibitor‐treated than in the control patients. Piroximone and enoximone showed significant vasodilatory properties at the arterial and venous side (= ‘venous pooling’), from which patients with heart failure would profit. Vasodilation could be observed for a longer period and was more pronounced in the enoximone‐treated than in the piroximone patients. Alterations in capillary skin blood flow measured by laser Doppler technique gave evidence for an improvement in nutritive microcirculation, which was slightly more pronounced in the enoximone patients.

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Section: Resultsmentioning

confidence: 99%

Circulatory effects of the PDE‐inhibitors piroximone and enoximone

Boldt¹,

Knothe²,

Zickmann³

et al. 1993

Brit J Clinical Pharma

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“…It cannot be definitely concluded from changes in skin capillary blood flow to vital organ blood flow and the present results must be interpreted carefully. In the critically ill, however, it has been suggested that monitoring of skin microcirculatory blood flow by laser Doppler technique may provide useful information related to total body perfusion [25,26].…”

Section: Measured Parameters and Data Pointsmentioning

confidence: 99%

Isolated circulatory response to intravenous administration of the ACE inhibitor enalaprilat.

Boldt

Knothe

Schindler

et al. 1994

Brit J Clinical Pharma

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The isolated vascular effects of intravenous administration of the angiotensin converting enzyme (ACE) inhibitor enalaprilat were investigated. Thirty male patients undergoing cardiopulmonary bypass (CPB) were studied. According to a randomized sequence, 0.04 mg kg‐1 enalaprilat (low‐dose, n = 10), 0.08 mg kg‐1 (high‐dose, n = 10) enalaprilat or saline solution as placebo (control group, n = 10) was given as an i.v. bolus during CPB. Changes in mean arterial pressure (MAP) and venous reservoir (RV) of the extracorporeal circulation were studied as indices of arterial resistance and venous capacitance. Mean arterial blood pressure (MAP) and peripheral vascular resistance (SVR) were significantly more reduced in the high‐dose enalaprilat group (MAP: ‐36 mm Hg after 9 min; SVR: ‐836 dyn s cm‐5) than in the low‐dose group (MAP: ‐13 mm Hg after 10 min). Volume of the reservoir (RV) decreased in both enalaprilat treated groups indicating additional (dose‐dependent) venous pooling effects of the substance (low‐dose: ‐ 300 ml; high‐dose: ‐520 ml; control group: ‐100 ml). Skin capillary blood flow measured by laser Doppler flowmetry (LDF) increased after injection of 0.04 mg kg‐1 enalaprilat, whereas it decreased significantly when MAP fell markedly in patients treated with high‐dose enalaprilat. I.v. enalaprilat had dose‐dependent vasodilating properties in the arterial and venous vessel system indicating reduction in pre‐ and afterload. Microcirculation in both enalaprilat treated groups improved as long as reduction in blood pressure was not limited.

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