Absolute quantification (ml blood/secâ¯∗â¯mm2 tissue) of normal vs. diabetic foot skin microvascular blood perfusion: Feasibility of FM-PPG measurements under clinical conditions.
Microvasc Res
; 123: 58-61, 2019 05.
Article
em En
| MEDLINE
| ID: mdl-30590061
ABSTRACT
Fluorescence-mediated photoplethysmography (FM-PPG) is the first routine clinical methodology by which to quantifiably measure tissue blood perfusion in absolute terms (mL blood/secâ¯∗â¯mm2 tissue). The FM-PPG methodology has been described in detail previously in this journal (MVR 114, 2017, 92-100), along with initial proof-of-concept measurements of blood perfusion in both ocular and forearm skin tissues. The motivation for the current study was to investigate whether FM-PPG can be used readily and routinely under realistic clinical conditions. The vehicle for doing this was to measure medial foot capillary blood flow, i.e., tissue perfusion, in 7 normal subjects, meanâ¯=â¯6.76⯱â¯2.29 E-005â¯mL/(secâ¯ââ¯mm2), and lesion-free areas of 8 type-2 diabetic patients with skin ulceration, meanâ¯=â¯4.67â¯+â¯3.15 E-005â¯mL/(secâ¯ââ¯mm2). Thus, perfusion in the diabetics was found to be moderately lower than that in the normal control subjects. Earlier skin perfusion measurements in medial forearms of 4 normal subjects, meanâ¯=â¯2.64â¯+â¯0.22 E-005â¯mL/(secâ¯ââ¯mm2), were lower than both the normal and diabetic foot perfusion measurements. Variability in the heartbeat-to-heartbeat blood perfusion pulses in the skin capillaries, defined as the ratio of the standard deviation among beat-to-beat pulses divided by the mean perfusion of those pulses, was determined for each subject. Average variability in foot skin was 21% in the diabetic population, versus 16% for normal subjects; and it was 18% in forearm skin. We conclude that absolute quantitative FM-PPG measurement of skin blood perfusion at the level of nutritive capillaries is feasible routinely under clinical conditions, allowing for quantitative measurement of skin tissue blood perfusion in absolute terms.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pele
/
Capilares
/
Fotopletismografia
/
Pé Diabético
/
Imagem de Perfusão
/
Corantes Fluorescentes
/
Verde de Indocianina
/
Microcirculação
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Microvasc Res
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Estados Unidos