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Microcirculatory Assessment of Arterial Below-Knee Stumps: Near-Infrared Spectroscopy Versus Transcutaneous Oxygen Tension-A Preliminary Study in Prosthesis Users.
Laroche, Davy; Barnay, José-Luis; Tourlonias, Bastien; Orta, Cyril; Obert, Christine; Casillas, Jean-Marie.
  • Laroche D; Centre d'Investigation Clinique INSERM 1432, Plateforme d'Investigation Technologique, Centre Hospitalier Universitaire de Dijon, Dijon, France; CAPS UMR 1093, INSERM, Université de Bourgogne Franche-Comté, F21000 Dijon, France.
  • Barnay JL; Pôle Rééducation-Réadaptation, Centre Hospitalier Universitaire de Dijon, Dijon, France.
  • Tourlonias B; Pôle Rééducation-Réadaptation, Centre Hospitalier Universitaire de Dijon, Dijon, France.
  • Orta C; Pôle Rééducation-Réadaptation, Centre Hospitalier Universitaire de Dijon, Dijon, France.
  • Obert C; Pôle Rééducation-Réadaptation, Centre Hospitalier Universitaire de Dijon, Dijon, France.
  • Casillas JM; Centre d'Investigation Clinique INSERM 1432, Plateforme d'Investigation Technologique, Centre Hospitalier Universitaire de Dijon, Dijon, France; CAPS UMR 1093, INSERM, Université de Bourgogne Franche-Comté, F21000 Dijon, France; Pôle Rééducation-Réadaptation, Centre Hospitalier Universitaire de Dijo
Arch Phys Med Rehabil ; 98(6): 1187-1194, 2017 06.
Article en En | MEDLINE | ID: mdl-28049004
ABSTRACT

OBJECTIVE:

To examine metrologic properties of near-infrared spectroscopy (NIRS) versus transcutaneous oxygen tension (TcPO2) for microcirculatory assessment of vascular transtibial stumps at the stabilized period of prosthesis fitting, as a preliminary step before exploring its ability to predict stump healing, considering the previously identified limits of TcPO2 (borderline area between 15 and 35mmHg).

DESIGN:

Prospective single-center observational study.

SETTING:

University-based rehabilitation center.

PARTICIPANTS:

Individuals with unilateral transtibial amputation for peripheral artery disease, at the definitive stage of prosthesis fitting, able to perform a 2-minute walk test (N=30).

INTERVENTIONS:

Not applicable. MAIN OUTCOME

MEASURES:

Test-retest, with the stump being evaluated in supine and inclined positions, first by NIRS (tissue saturation index [TSI], oxyhemoglobin, deoxyhemoglobin, and total hemoglobin) and second by TcPO2. Subjects carried out a 2-minute walk test and visual analog scales (wound healing and pain).

RESULTS:

Feasibility and tolerance of NIRS were satisfactory. The reliability of NIRS and TcPO2 values was good (intraclass correlation coefficient >0.7; P<.05). No significant relation was found between NIRS and TcPO2. No responsiveness (inclined vs supine) was reported (P>.05). A significant relation between TSI and the 2-minute walk test (r>.49, P<.05) was found.

CONCLUSIONS:

NIRS is painless, complication-free, and feasible, with good reliability. NIRS evaluates others domain than TcPO2 that are more linked to metabolic adaptation. Its capacity to predict stump healing and tolerance to early prosthesis fitting is therefore interesting to estimate in future studies.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Oxígeno / Espectroscopía Infrarroja Corta / Amputación Quirúrgica / Muñones de Amputación / Microcirculación Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Año: 2017 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Oxígeno / Espectroscopía Infrarroja Corta / Amputación Quirúrgica / Muñones de Amputación / Microcirculación Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Año: 2017 Tipo del documento: Article