Dynamics of Local Temperature in the Fingertips After the Cuff Occlusion Test: Infrared Diagnosis of Adaptation Reserves to Hypoxia and Assessment of Survivability of Victims at Massive Blood Loss.

ABSTRACT

Background: Since changes in the tone and size of the lumen of peripheral blood vessels with massive blood loss are part of the mechanism of adaptation to hypoxia, which automatically changes the flow of warm blood to the fingertips, it was assumed that infrared thermography of the fingertips can reveal the dynamics of heat release in them, reflecting the reactivity of peripheral blood vessels and adaptation to hypoxia. It was assumed that the cuff occlusion test (COT) would assess the available reserves of adaptation to hypoxia and improve the accuracy of resistance to hypoxia and the prognosis of survival in massive blood loss. Methods: The temperature change in the fingertips before and after the application of COT in the corresponding hand was studied in healthy adult volunteers, donors after donating 400 mL of blood and in victims with blood loss of less than or more than 35%. Results: During COT, the temperature in the fingers of the ischemic hand decreased in all the subjects. After COT the temperature in the fingers rose above the baseline level in healthy volunteers and in donors who donated 400 mL of blood, but did not increase in most patients with massive blood loss, of which some patients died despite the treatment. Conclusions: We report the dynamics of local temperature in the finger pads after the COT in healthy adult volunteers, in donors after they donated 400 mL of venous blood each, and in victims with massive blood loss less than or greater than 35%. It is shown that the detection of local hyperthermia in the finger pads after occlusion is a sign of good adaptation to hypoxia and the probability of survivability of the victim with massive blood loss.