Quantitative measurement of sympathetic neuropathy in patients with diabetes mellitus

Nasimi, Soheila; Mearns, Alan J.; Harness, J.B.; Heath, I. D.

doi:10.1016/0141-5425(91)90127-s

Cited by 7 publications

(3 citation statements)

References 7 publications

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“…The pulse oximeter perfusion index (PI) 15,16 is the ratio of the amplitude of the ''AC'' signal to the baseline ''DC'' signal. The PI has been correlated with changes in vascular sympathetic tone 17,18 and blood volume 13,14 and has been validated with assessments of perfusion made by near-infra-red spectroscopy. 16 Previous reports from our group suggest that the PI is a more reliable and a more sensitive marker of sympathectomyrelated vasodilatation than either blood pressure changes or cutaneous temperature changes.…”

Section: Indices Of Sympathectomymentioning

confidence: 99%

Vasodilatation médiée par sympathectomie: une étude randomisée de détermination de la concentration de bupivacaïne péridurale

Ginosar

Weiniger

Kurz

et al. 2009

Can J Anesth/J Can Anesth

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Purpose We tested the hypothesis that the development of sympathectomy-mediated vasodilatation is dependent on the concentration rather than the dose of epidural local anesthetic administered. Methods Sixty subjects receiving lumbar epidural bupivacaine were randomised to one of three groups: A: 10 ml 0.5% (50 mg); B: 10 ml 0.25% (25 mg); and C: 40 ml 0.0625% (25 mg). Groups A and B had equal volume but a twofold difference in drug dose, while groups B and C had equal drug dose, but a fourfold difference in drug volume. At baseline and 5, 10, and 20 min following epidural bupivacaine administration, we assessed the following indices of sympathectomy: pulse oximeter perfusion index in the toe and finger, skin temperature in the toe and finger, and mean arterial pressure. We also assessed sensory level (pinprick, cold, and light touch) and motor block. Results There was an increase in the pulse oximeter perfusion index by 20 min of 280%, 303%, and 59% in groups A, B, and, C, respectively. There was a significant sympathectomy-mediated vasodilatation in the toe for both groups A (P = 0.002) and B (P \ 0.001) but not C (P = 0.22). Vasoconstriction in the finger was observed in group A only (P = 0.015) but not in group B (P = 0.09) or group C (P = 0.20). There were similar blood pressure changes and similar sensory changes in all groups. The intensity of motor block increased with increasing drug concentration. Conclusions Our observations suggest that drug concentration is more important than drug dose in determining the degree of sympathectomy following lumbar epidural local anesthesia. RésuméObjectif Nous avons teste´l'hypothe`se selon laquelle l'apparition d'une vasodilatation me´die´e par sympathectomie e´tait lie´e à la concentration plutôt qu'a`la dose d'anesthe´sique local pe´ridural administre´. Méthode Soixante patients recevant de la bupivacaı¨ne pe´ridurale lombaire ont e´te´randomise´s en trois groupes : A : 10 ml 0,5 % (50 mg); B : 10 ml 0,25 % (25 mg); et C : 40 ml 0,0625 % (25 mg). Les groupes A et B ont reçu un volume e´quivalent mais la dose de me´dicament e´tait double´e pour le groupe A, alors que les groupes B et C ont reçu une dose e´gale, mais le volume de me´dicament a e´teq uadruple´pour le groupe C. Nous avons e´value´les indices de sympathectomie suivants aux niveaux de base ainsi qu'a5 , 10 et 20 minutes apre`s l'administration de la bupivacaı¨ne pe´ridurale : indice de perfusion de l'oxyme`tre de pouls a`l'orteil et au doigt, tempe´rature cutane´e à l'orteil et au doigt, et tension arte´rielle moyenne. Nous avons e´galement e´value´le niveau sensoriel (piquˆre a`l'aiguille, froid et toucher le´ger) et le bloc moteur. Résultats Sur la base de l'indice de perfusion de l'oxyme`tre de pouls, nous avons observe´une vasodilatation 123Can J Anesth/J Can Anesth (2009) 56:213-221 DOI 10.1007 me´die´e par sympathectomie significative dans l'orteil pour les groupes A (P = 0,002) et B (P \ 0,001) mais pas dans le groupe C (P = 0,22). La vasoconstriction au doigt a e´teó bserve´e uniquement ...

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Section: Indices Of Sympathectomymentioning

confidence: 99%

Vasodilatation médiée par sympathectomie: une étude randomisée de détermination de la concentration de bupivacaïne péridurale

Ginosar

Weiniger

Kurz

et al. 2009

Can J Anesth/J Can Anesth

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“…Changes in pulse with orthostatic stress have been assessed by several researchers. Nasimi et al (1991) investigated sympathetic neuropathy in patients with diabetes mellitus by monitoring PPG frequency characteristics throughout a supine-to-standing posture challenge. A significant difference in the lower frequency components with standing was found in healthy subjects, but with less change detected in the patient group.…”

Section: Orthostasismentioning

confidence: 99%

Photoplethysmography and its application in clinical physiological measurement

2007

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Photoplethysmography (PPG) is a simple and low-cost optical technique that can be used to detect blood volume changes in the microvascular bed of tissue. It is often used non-invasively to make measurements at the skin surface. The PPG waveform comprises a pulsatile ('AC') physiological waveform attributed to cardiac synchronous changes in the blood volume with each heart beat, and is superimposed on a slowly varying ('DC') baseline with various lower frequency components attributed to respiration, sympathetic nervous system activity and thermoregulation. Although the origins of the components of the PPG signal are not fully understood, it is generally accepted that they can provide valuable information about the cardiovascular system. There has been a resurgence of interest in the technique in recent years, driven by the demand for low cost, simple and portable technology for the primary care and community based clinical settings, the wide availability of low cost and small semiconductor components, and the advancement of computer-based pulse wave analysis techniques. The PPG technology has been used in a wide range of commercially available medical devices for measuring oxygen saturation, blood pressure and cardiac output, assessing autonomic function and also detecting peripheral vascular disease. The introductory sections of the topical review describe the basic principle of operation and interaction of light with tissue, early and recent history of PPG, instrumentation, measurement protocol, and pulse wave analysis. The review then focuses on the applications of PPG in clinical physiological measurements, including clinical physiological monitoring, vascular assessment and autonomic function.

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“…Photoplethysmography (PPG) has been a commonly-used optical sensing method that collects light reflected or transmitted through skin so as to noninvasively monitor the pulsation of blood flow in subcutaneous blood vessels. Since blood flow pulsations can reflect the operating conditions of the circulatory and respiratory systems of the human body, PPG signals can be used as indicators for many diseases, such as endothelial dysfunction, sympathetic neuropathy, cardiac arrhythmia, vasospasm, microcirculation, autonomic neuropathy, orthostatic hypotension, migraine, and peripheral artery disease [1,2,3,4]. Due to the simple measurement structure, PPG sensing technology has been widely used in wearable devices to achieve heart rate detection in recent years [5,6,7,8,9,10].…”

Section: Introductionmentioning

confidence: 99%

MW-PPG Sensor: An on-Chip Spectrometer Approach

Chang

Choi

et al. 2019

Sensors

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Multi-wavelength photoplethysmography (MW-PPG) sensing technology has been known to be superior to signal-wavelength photoplethysmography (SW-PPG) sensing technology. However, limited by the availability of sensing detectors, many prior studies can only use conventional bulky and pricy spectrometers as the detectors, and hence cannot bring the MW-PPG technology to daily-life applications. In this study we developed a chip-scale MW-PPG sensor using innovative on-chip spectrometers, aimed at wearable applications. Also in this paper we present signal processing methods for robustly extracting the PPG signals, in which an increase of up to 50% in the signal-to-noise ratio (S/N) was observed. Example measurements of saturation of peripheral blood oxygen (SpO2) and blood pressure were conducted.

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Quantitative measurement of sympathetic neuropathy in patients with diabetes mellitus

Cited by 7 publications

References 7 publications

Vasodilatation médiée par sympathectomie: une étude randomisée de détermination de la concentration de bupivacaïne péridurale

Vasodilatation médiée par sympathectomie: une étude randomisée de détermination de la concentration de bupivacaïne péridurale

Photoplethysmography and its application in clinical physiological measurement

MW-PPG Sensor: An on-Chip Spectrometer Approach

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