Transcutaneous Oxygen and Carbon Dioxide during Treatment of Critical Limb Ischemia with Iloprost, a Prostacyclin Derivative

Abstract

The effect of intravenous iloprost treatment (median rate: 1.6; range: 1-2 ng/ kg/min; 6 h daily over 4 weeks) on transcutaneous pO₂ and pCO₂ was studied in 8 patients with bilateral peripheral obstructive arterial disease and monolateral critical limb ischemia. Tensiometric determinations were obtained at both metatarsi in the supine and dependent position. In critically ischemic limbs, supine transcutaneous pO₂ changed erratically during iloprost treatment, increasing in only three out of eight lower limbs. At variance with its inconsistent behavior in the supine position, dependent pO₂ increased during drug administration (p < 0.02). Transcutaneous pCO₂ was unchanged by iloprost. In the contralateral, non-symptomatic limb, both supine and dependent pO₂ values were increased by the drug, suggesting that systemic hemodynamic changes may participate in its effect on transcutaneous gas tension, even at infusion rates clinically titrated to avoid evident changes in blood pressure and heart rate.

The use of an extract ofHypericum perforatumandAzadirachta indicain advanced diabetic foot: an unexpected outcome

“…During the assessment visit on 6 April 2011, echo-color Doppler showed a sub-genicolate arteriopathy to both the feet, which resulted more serious on the left foot from supine/depend  transcutaneous oxygen and carbon dioxide partial pressure, performed according to Melillo et al 3. Nevertheless, this exam highlighted microvascular parameters indicating a good metabolic compensation of the tissue on both the legs (table 1).…”

A Review of Microvascular Measurements in Wound Healing

“…In the 1990s, measurements using a combined sensor to measure O 2 and CO 2 (Clark and Severinghaus electrodes) were reported. [69][70][71][72] In fact, the CO 2 produced by tissue metabolism is carried by the red cells to be eliminated through the lungs and kidneys and the excess amount is diffused at the cutaneous level and is measured as CO 2 tension by the Severinghaus electrode (Figure 3).…”

“…It is also reported that the combined measurement of O 2 and CO 2 is very useful in the therapeutic monitoring of PAOD and that the presence of diabetic disease has little demonstrable influence. 68,69,71…”

“…The study of the skin microcirculation 82,83 allows the monitoring of the evolutive stage of the PAOD 71,84 and the evaluation of response to medical treatment 69,85 or to revascularization of the symptomatic limbs in the absence of critical ischemia.…”

Effects of Chronic Simulated Hypobaric Hypoxia on Mouse Spermatogenesis

“…Its activity enhances EPO synthesis, local neoangiogenesis and vasodilation (Bunn & Poyton, 1996;Giordano & Johnson, 2001;Semenza, 2003) and anaerobic metabolism (Dang & Semenza, 1999;Seagrovez et al, 2001). Besides, HIF-1 regulates vasomotricity (Melillo et al, 1995;Nguyen & Claycomb, 1999) and cellular cycle (Feldser et al, 1999;Krishnamachary et al, 2003).…”