Total and Nutritional Blood Flow in the Finger

Coffman, Jay D.

doi:10.1042/cs0420243

Cited by 90 publications

(51 citation statements)

References 11 publications

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“…The capillary circulation is functionally situated in parallel to the arteriovenous shunts and is thought to have the primary function of skin nutrition. It has been estimated that 80-90% of total skin blood flow passes through thermoregulatory arteriovenous shunts and does not enter the capillary bed (12). The observations on the nutritive component of skin blood flow in diabetic patients are confusing.…”

Section: Discussionmentioning

confidence: 99%

“…The skin microcirculation is influenced by endothelial factors (7)(8)(9), the sympathetic nervous system (10,11), and metabolic factors (4,6), which may all deteriorate in the course of diabetic disease. Normally, the major part of the overall skin blood flow is involved in thermoregulation and Ͻ 10% of the total skin blood flow passes through the skin capillaries to supply tissue nutrition (12)(13)(14)(15). While total skin perfusion is increased in diabetes mellitus, there is some evidence for an impaired nutritional capillary blood cell velocity (CBV) in diabetic patients (13,14).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Biological activity of C-peptide on the skin microcirculation in patients with insulin-dependent diabetes mellitus.

Forst¹,

Kunt²,

Pohlmann³

et al. 1998

J. Clin. Invest.

123

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Abstract19 insulin-dependent diabetes mellitus (IDDM) patients participated in a randomized double-blind crossover investigation to investigate the impact of human C-peptide on skin microvascular blood flow. The investigation was also carried out with 10 healthy volunteers. Blood pressure, heart rate, blood sugar, and C-peptide levels were monitored during a 60-min intravenous infusion period of C-peptide (8 pmol kg

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biological activity of C-peptide on the skin microcirculation in patients with insulin-dependent diabetes mellitus.

Forst¹,

Kunt²,

Pohlmann³

et al. 1998

J. Clin. Invest.

123

View full text Add to dashboard Cite

show abstract

“…In between, two types of parallel situated blood vessels are located, i.e. surface capillary loops serving nutri tional demands and arteriovenous anastomoses (AVA), essential for body temperature homeostasis [1], A t room temperature skin blood flow by far exceeds nutritional needs; 80-90% of total skin blood flow bypasses the nutritional through the AVA [2], Cutaneous vasculature is predominantly under neural control from a dense sympathetic adrenergic nerve supply, especially in the acral regions. Vasocon strictor sympathetic skin nerve fibres are the efferent arm of, respectively, thermoregulatory reflexes, baroreceptor reflexes, chemoreceptor reflexes and of the reflex response to upright position and exercise [3].…”

Section: Introductionmentioning

confidence: 99%

The influence of ulnar nerve blockade on skin microvascular blood flow*

Netten

Wollersheim

Gielen

et al. 1995

Eur J Clin Investigation

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Abstract. Microvascular research is seriously ham pered by the great temporal and spatial variability of the measured skin blood flow and variation in sympa thetic vasomotor reflexes within and between persons. Therefore skin vasomotor reflexes were studied before and after ulnar nerve blockade within the same person, resulting in a temporal complete denervation of the fifth finger and partial denervation of the fourth finger. Skin temperature and laser Doppler flux (LDF) were registrated to measure predominantly arteriove nous shuntflow. Measurements were performed on the palmar tip of the second and fifth finger in nine healthy volunteers, at baseline, and during a sympa thetic reflex test (i.e. inspiratory gasp) and postural response test. Beat-to-beat digital blood pressure was recorded from the third and fourth finger by a Finapres device. Baseline capillary blood cell velocity (CBV) was measured at the nailfold of the second and the fifth finger. After ulnar blockade baseline skin temperature, LD F and CBV increased significantly, with respectively (mean ± SE) 3*2±0*9°C, 20*9 ±5*9 relative perfusion units and 0*79 ±0*40 m m " 1 s. The percentage LDF decrease of the fifth finger during inspiratory gasp was 48*2 ±5*3% before and 3*1 ±0-9% after blockade. The postural response test showed a decrease in LDF of the fifth finger with no significant difference before and after block ade, respectively 12*3 ±14*7% and 8*0±2*7%, while no difference was found in the increase in digital blood pressure in the denervated fourth finger compared to both the same finger before blockade and to the third non-blocked finger. It is concluded that ulnar nerve blockade enables the study of sympathetic skin vasomotor reflexes by comparison of a denervated and a non-denervated vascular bed within the same person. After ulnar blockade arteriovenous shunt flow as well as nutritional capillary blood flow increased significantly. Postural vasoconstrictor response is not abolished by ulnar blockade, suggesting that local regulatory mechanisms are more important.

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“…The autonomic nervous system plays an important role in regulating peripheral blood flow with sympathetic nerve fibers regulating flow through their action on the A-V shunts physiologically dedicated to thermal regulation [5]. The failure of sympathetic control results in a vasodilatation with increased flow through the A-V shunts and therefore an increased total peripheral blood flow [6].…”

Section: Discussionmentioning

confidence: 99%

Autonomic neuropathy and transcutaneous oxymetry in diabetic lower extremities

et al. 1994

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Transcutaneous oxygen tension is a useful method with which to assess the functional status of skin blood flow. The reduced values observed in diabetic patients have been interpreted as a consequence of peripheral vascular disease. However, diabetic patients show lower transcutaneous oxygen tension values than control subjects with equivalent degrees of peripheral vascular disease, suggesting that additional factors are involved. Since the autonomic nervous system influences peripheral circulation, we studied the relationship between autonomic neuropathy and foot transcutaneous oxymetry in non-insulin-dependent diabetic (NIDDM) patients without peripheral vascular disease. The following age-matched patients were selected and evaluated: control subjects, C, (n = 20), NIDDM patients without autonomic neuropathy, D, (n = 16) and with autonomic neuropathy, DN, (n = 20). All diabetic patients showed lower transcutaneous oxygen tension values than control subjects, while no differences were observed between the diabetic patients with and without autonomic neuropathy. In addition the saturation index that increases in the presence of autonomic neuropathy does not correlate with foot TcPO2. In conclusion autonomic neuropathy does not influence foot TcPO2 and therefore it is unlikely that it contributes to development of foot lesions during induction of foot skin ischaemia

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Total and Nutritional Blood Flow in the Finger

Cited by 90 publications

References 11 publications

Biological activity of C-peptide on the skin microcirculation in patients with insulin-dependent diabetes mellitus.

Biological activity of C-peptide on the skin microcirculation in patients with insulin-dependent diabetes mellitus.

The influence of ulnar nerve blockade on skin microvascular blood flow*

Autonomic neuropathy and transcutaneous oxymetry in diabetic lower extremities

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