Sensitive detection of hemodynamic failure during orthostatic stress in patients with diabetic polyneuropathy using a mini laser Doppler blood flowmeter

Goma, Masaki; Kaneshige, Masahiro; Ichijo, Sayaka; Ichijo, Masashi; Shindo, Hiroko; Terada, Nobuyuki; Yokomichi, Hiroshi; Yamagata, Zentaro; Kitamura, Kenichiro; Shimura, Hiroki; Kobayashi, Tetsuro

doi:10.1016/j.jash.2016.11.003

Cited by 4 publications

(5 citation statements)

References 42 publications

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“…In conjunction with LDF, the mechanism used to measure the capillary blood flow directly under the skin during dialysis has been previously reported [28–30]. This method was developed to measure the blood flow at the skin surface and to evaluate the function of autonomic neurons.…”

Section: Discussionmentioning

confidence: 99%

“…A ROC analysis to determine the cut-off point was based on this logistic analysis, and the cut-off point was defined according to Youden’s method [25–27]. A further covariate-adjusted ROC analysis was performed based on the logistic analysis using covariates obtained from the stepwise method for logistic analysis of outcomes [27–30]. All statistical analyses were performed using SAS 9.3 (SAS).…”

Section: Methodsmentioning

confidence: 99%

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Laser Doppler blood flowmeter as a useful instrument for the early detection of lower extremity peripheral arterial disease in hemodialysis patients: an observational study

Ishii

Takabe²,

Yanagawa³

et al. 2019

BMC Nephrol

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BackgroundA simpler method for detecting atherosclerosis obliterans is required in the clinical setting. Laser Doppler flowmetry (LDF) is easy to perform and can accurately detect deterioration in skin perfusion. We performed LDF for hemodialysis patients to determine the correlations between blood flow in the lower limbs and peripheral arterial disease (PAD).MethodsThis retrospective study included 128 hemodialysis patients. Patients were categorized into the non-PAD group (n = 106) and PAD group (n = 22), 14 early stage PAD patients were included in the PAD group. We conducted LDF for the plantar area and dorsal area of the foot and examined skin perfusion pressure (SPP) during dialysis.ResultsSPP-Dorsal Area values were 82.1 ± 22.0 mmHg in the non-PAD, and 59.1 ± 20.3 mmHg in PAD group, respectively (p < 0.05). The LDF-Plantar blood flow (Qb) values were 32.7 ± 15.5 mL/min in non-PAD group and 21.5 ± 11.3 mL/min in PAD group (p < 0.001). A total of 21 non-PAD patients underwent LDF before and during dialysis. The LDF-Plantar-Qb values were 36.5 ± 17.6 mL/min before dialysis and 29.6 ± 17.7 mL/min after dialysis (p < 0.05). We adjusted SPP and LDF for PAD using logistic regression, SPP-Dorsal-Area and LDF-P were significantly correlated with PAD (p < 0.05). The receiver-operating characteristic curve analysis indicated cut-off values of 20.0 mL/min for LDF-Plantar-Qb during dialysis.ConclusionLDF is a simple technique for sensitive detection of early-stage PAD. This assessment will help physicians identify early-stage PAD, including Fontaine stage II in clinical practice, thereby allowing prompt treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Laser Doppler blood flowmeter as a useful instrument for the early detection of lower extremity peripheral arterial disease in hemodialysis patients: an observational study

Ishii

Takabe²,

Yanagawa³

et al. 2019

BMC Nephrol

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“…In the present case, EBF during walking was measured on a separate day from the leg bathing as an indicator of peripheral circulation. Goma et al ( 2015) [11] and Goma et al (2017) [12] reported that immediately after orthostasis, EBF showed a transient decrease and the recovery response synchronized with arterial blood pressure in healthy subjects and that patients with diabetic neuropathy showed reduced auricular blood flow. From the above, they mentioned the possibility of indirectly assessing blood pressure regulation by the autonomic nervous system by measuring EBF.…”

Section: Discussionmentioning

confidence: 99%

Antihypertensive Effects of Three Days of Leg Bathing on a Patient With Stanford Type A Acute Aortic Dissection After Surgery: A Case Report

Takahashi,

Hasegawa,

Okura

2023

Cureus

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Thermal therapy is expected to have an antihypertensive effect associated with increased blood flow and vasodilation. Here, we report a case of postoperative aortic dissection in which leg bathing was effective for treating hypertension. A 50-year-old female (body mass index: 25.3 kg/m 2 ) underwent emergency surgery for Stanford type A aortic dissection and started early mobilization the following day. Even on postoperative day (POD) 28, the patient had repeated deviations from the blood pressure limit (systolic pressure 90-140 mmHg) during a 200-m walk. Therefore, leg bathing (42°C for 20 minutes) before walking for three days was started on POD 38. No changes in medications or other medical interventions from POD 28 until discharge from the hospital were made. Mean blood pressure values during the seven days before leg bathing were 151/94 mmHg at rest and 168/107 mmHg after walking, with a maximum value of 180/113 mmHg. After leg bathing, blood pressure after walking was 147/96 mmHg on day 1, 149/96 mmHg on day 2, and 127/82 mmHg on day 3. The mean blood pressure values during the seven days after three days of leg bathing were 137/81 mmHg at rest, 147/89 mmHg after walking, and 167/97 mmHg at maximum, with no more deviations from the blood pressure limit at rest and a slight increase with exercise. Three days of leg bathing produced sufficient antihypertensive effects for this patient. The findings in this case indicate the need for comparative studies with a control group in the future.

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“…10) The portable LDF was developed to evaluate the functions of the autonomic nervous system by measuring the blood flow at the skin surface. While portable LDF has been applied in managing several diseases, [11][12][13] its usefulness has not yet been evaluated for diagnosing PAD in dialysis patients. Since the pulse amplitude measured with the portable LDF showed a high diagnostic value for PAD in dialysis patients and the measurement could easily be made during an HD session, we consider that measurement of the pulse amplitude with a portable LDF is a superior to measurement of the ABI and TBI as a screening tool for PAD.…”

Section: Discussionmentioning

confidence: 99%

Pulse Amplitude Measured with a Portable Laser Doppler Flowmeter Is Useful for Screening of Dialysis Patients for Peripheral Arterial Disease: An Observational Study

Saito¹,

Jingu²,

Osawa³

et al. 2022

Annals of Vascular Diseases

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Objective:The objective of this study was to use a portable laser Doppler flowmeter (LDF) to measure the toe blood flow and pulse amplitude as a screening test for peripheral arterial disease (PAD) in dialysis patients and compare the diagnostic abilities of the aforementioned parameters measured using an LDF with those of the ankle-brachial index (ABI) and toe brachial index (TBI). Methods: The 14 patients in this retrospective study received maintenance hemodialysis (HD). We measured the blood flow and pulse amplitude on the ventral side of the first toe with a portable LDF while the patients were undergoing an HD session. The correlations between the blood flow/pulse amplitude in the toe and the ABI/TBI were examined. Results: Both the ABI and TBI had a strong correlation with pulse amplitude. The sensitivity and specificity of the pulse amplitude measured with the LDF for detecting PAD in HD patients as determined by a receiver operating characteristic curve analysis were 1.00 and 0.88, respectively. Conclusion: Measuring the pulse amplitude in the toe with a portable LDF may serve as a simple and useful screening test for PAD in HD patients.

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Sensitive detection of hemodynamic failure during orthostatic stress in patients with diabetic polyneuropathy using a mini laser Doppler blood flowmeter

Cited by 4 publications

References 42 publications

Laser Doppler blood flowmeter as a useful instrument for the early detection of lower extremity peripheral arterial disease in hemodialysis patients: an observational study

Laser Doppler blood flowmeter as a useful instrument for the early detection of lower extremity peripheral arterial disease in hemodialysis patients: an observational study

Antihypertensive Effects of Three Days of Leg Bathing on a Patient With Stanford Type A Acute Aortic Dissection After Surgery: A Case Report

Pulse Amplitude Measured with a Portable Laser Doppler Flowmeter Is Useful for Screening of Dialysis Patients for Peripheral Arterial Disease: An Observational Study

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