Effect of arteriovenous fistula on cutaneous microvascular circulation in hemodialysis patients
Cutaneous microvascular blood flow (CMBF) was measured by laser Doppler flowmetry, to examine the effect of blood access (BA) on cutaneous microvascular circulation. We studied 10 normal subjects and 10 hemodialysis (HD) patients (male 3, female 7) who had arteriovenous shunt on the right or left fo...
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| Published in | Journal of Japanese Society for Dialysis Therapy Vol. 22; no. 2; pp. 205 - 209 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society for Dialysis Therapy
1989
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| Online Access | Get full text |
| ISSN | 0911-5889 1884-6211 |
| DOI | 10.4009/jsdt1985.22.205 |
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| Abstract | Cutaneous microvascular blood flow (CMBF) was measured by laser Doppler flowmetry, to examine the effect of blood access (BA) on cutaneous microvascular circulation. We studied 10 normal subjects and 10 hemodialysis (HD) patients (male 3, female 7) who had arteriovenous shunt on the right or left forearm. Two patients showed luxurious perfusion. We made flow measurements in the center of the back of both hands in the resting supine position before and after HD, and 1 and 2 hours after HD started. 1) CMBF on the BA side (6.36-30.7ml/min/100cc) was markedly higher than on the non-BA side (1.62-4.21ml/min/100cc) in 4 patients, including 2 with swollen hands. This increased flow gradually decreased during HD, but 3 of the 4 patients showed transient elevation 1 hour after HD started. Of these 4 patients, the CMBF after HD on the BA side in the 2 patents with swollen hands were 3.3 and 7.3 times greater than on the non-BA side, but in the other 2 patients, they were 1.4 and 1.7 times. 2) The CMBF before HD in the remaining 6 patients ranged from 3.09-5.30ml/min/100cc on the non-BA side and 1.57-5.05ml/min/100cc on the non-BA side, and it did not change during HD. 3) There was no significant difference in CMBF on the non-BA side between the patients and normal subjects (1.10-4.34ml/min/100cc), and no correlation between CMBF and peripheral venous hematocrit. It is suggested that the increase in CMBF on the BA side depends on the massive inflow of arterial blood through the BA, and the measurement of CMBF is useful for the treatment and prevention of Iuxurious perfusion induced by BA. |
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| AbstractList | Cutaneous microvascular blood flow (CMBF) was measured by laser Doppler flowmetry, to examine the effect of blood access (BA) on cutaneous microvascular circulation. We studied 10 normal subjects and 10 hemodialysis (HD) patients (male 3, female 7) who had arteriovenous shunt on the right or left forearm. Two patients showed luxurious perfusion. We made flow measurements in the center of the back of both hands in the resting supine position before and after HD, and 1 and 2 hours after HD started. 1) CMBF on the BA side (6.36-30.7ml/min/100cc) was markedly higher than on the non-BA side (1.62-4.21ml/min/100cc) in 4 patients, including 2 with swollen hands. This increased flow gradually decreased during HD, but 3 of the 4 patients showed transient elevation 1 hour after HD started. Of these 4 patients, the CMBF after HD on the BA side in the 2 patents with swollen hands were 3.3 and 7.3 times greater than on the non-BA side, but in the other 2 patients, they were 1.4 and 1.7 times. 2) The CMBF before HD in the remaining 6 patients ranged from 3.09-5.30ml/min/100cc on the non-BA side and 1.57-5.05ml/min/100cc on the non-BA side, and it did not change during HD. 3) There was no significant difference in CMBF on the non-BA side between the patients and normal subjects (1.10-4.34ml/min/100cc), and no correlation between CMBF and peripheral venous hematocrit. It is suggested that the increase in CMBF on the BA side depends on the massive inflow of arterial blood through the BA, and the measurement of CMBF is useful for the treatment and prevention of Iuxurious perfusion induced by BA. |
| Author | Aoki, Tadashi Maruyama, Yoshifumi Mabuchi, Hisao Nakahashi, Hisamitsu Kakiuchi, Takeshi |
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| References | 7) R S Chung: Blood flow in colonic anastomoses, effect of stapling and suturing. Ann Surg 206: 335-339, 1987 1) 太田和夫: ブラッドアクセスの外科的合併症とその処置, ブラッドアクセス -作り方と使い方-: 217-285, 南江堂, 東京, 1982 14) Gaehtgens P: ‘Regulation’ of capillary haemotocrit. Int J Microcirc: Clin Exp 3: 147-160, 1984 4) Winsor T, Haumschild DJ, Winsor DW, Wang Y, Luong TN: Clinical application of laser Doppler flowmetry for measurement of cutaneous circulation in health and disease. Angiology 38: 727-736, 1987 12) Haumschild DJ: Microvascular blood flow measurement by laser Doppler flowmetry. TSI APPLICATION NOTE 1986 18) Vicaut E, Stucker O, eisseire BT, uvelleroy MD: Effects of changes in systemic hematocrit on the microcirculation in rat cremaster muscle. Int J Microcirc: Cin Exp 6: 225-235, 1987 5) Taylor WF, Johnson JM, Kosiba WA, Kwan CM: Graded cutaneous vascular responses to dynamic leg exercise. J Appl Physiol 64: 1803-1809, 1988 8) Jenkins SD, Sepka RS, Barwick WJ, Serafin D, Klitzman B: Routine clinical use of laser doppler flowmeter to monitor free tissue transfer. J Reconstructive Microsurg 87: 281-283, 1987 9) Song CV, Rhee JG, Haumschild DJ: Continuous and non invasive quantification of heat-induced changes in blood flow in the skin and RIF-1 tumor of mice by laser Doppler flowmetry. Int J Hyperthermia 3: 71-77, 1987 3) Nilsson GE, Tenland T, Öberg PÅ: A new instrument for continuous measurement of tissue blood flow by light beating spectroscopy. IEEE Trans Biomed Eng BME-27: 12-19, 1980 2) Riva C, Ross B, Benedek G: Laser doppler measurements of blood flow in capillary tubes and retinal arteries. Invest Opthalmol 11: 936-944, 1972 10) Druce HM, Bonner RF, atow CP, Choo P, Summers RJ, Kaliner MA: Response of nasal blood flow to neurohormones as measured by laserdoppler velocimetry. J Appl Physiol: Respirat Environ Exercise Physiol 57: 1276-1283, 1984 13) 織笠長俊: 血液透析時における末梢血行諸量の変化. 岩手医誌 38: 209-223, 1986 6) Rosenblum BR, Bonner RF, Oldfield EH: Intraoperative measurement of cortical blood flow adjacent to cerebral AVM using laser doppler velocimetry. J Neurosurg 66: 396-399, 1987 11) Calibration verification of TSI LASERFLO® BPM 403. 1986, TSI Incorporated, St. Paul. 15) Linderkamp O, Versmold HT, Strohhacker I, Messow-Zahn K, Riegel KP, Betke K: Capillary-venous hematocrit differences in newborn infants. Eur J pediatr 127: 9-14, 1977 17) Rodgers GP, Schechter AN, Noguchi CT, Klein HG, Nienhuis AW, Bonner RF: Periodic microcirculatry flow in patients with sickle-cell disease. N Eng J Med 311: 1534-1538, 1984 16) Mchedlishvili G, Varazashvili M: Hematocrit in cerebral capillaries and veins under control and ischemic conditions. J Cereb Blood Flow Metab 7: 739-744, 1987 |
| References_xml | – reference: 9) Song CV, Rhee JG, Haumschild DJ: Continuous and non invasive quantification of heat-induced changes in blood flow in the skin and RIF-1 tumor of mice by laser Doppler flowmetry. Int J Hyperthermia 3: 71-77, 1987 – reference: 4) Winsor T, Haumschild DJ, Winsor DW, Wang Y, Luong TN: Clinical application of laser Doppler flowmetry for measurement of cutaneous circulation in health and disease. Angiology 38: 727-736, 1987 – reference: 7) R S Chung: Blood flow in colonic anastomoses, effect of stapling and suturing. Ann Surg 206: 335-339, 1987 – reference: 15) Linderkamp O, Versmold HT, Strohhacker I, Messow-Zahn K, Riegel KP, Betke K: Capillary-venous hematocrit differences in newborn infants. Eur J pediatr 127: 9-14, 1977 – reference: 3) Nilsson GE, Tenland T, Öberg PÅ: A new instrument for continuous measurement of tissue blood flow by light beating spectroscopy. IEEE Trans Biomed Eng BME-27: 12-19, 1980 – reference: 12) Haumschild DJ: Microvascular blood flow measurement by laser Doppler flowmetry. TSI APPLICATION NOTE 1986 – reference: 18) Vicaut E, Stucker O, eisseire BT, uvelleroy MD: Effects of changes in systemic hematocrit on the microcirculation in rat cremaster muscle. Int J Microcirc: Cin Exp 6: 225-235, 1987 – reference: 2) Riva C, Ross B, Benedek G: Laser doppler measurements of blood flow in capillary tubes and retinal arteries. Invest Opthalmol 11: 936-944, 1972 – reference: 8) Jenkins SD, Sepka RS, Barwick WJ, Serafin D, Klitzman B: Routine clinical use of laser doppler flowmeter to monitor free tissue transfer. J Reconstructive Microsurg 87: 281-283, 1987 – reference: 6) Rosenblum BR, Bonner RF, Oldfield EH: Intraoperative measurement of cortical blood flow adjacent to cerebral AVM using laser doppler velocimetry. J Neurosurg 66: 396-399, 1987 – reference: 1) 太田和夫: ブラッドアクセスの外科的合併症とその処置, ブラッドアクセス -作り方と使い方-: 217-285, 南江堂, 東京, 1982 – reference: 5) Taylor WF, Johnson JM, Kosiba WA, Kwan CM: Graded cutaneous vascular responses to dynamic leg exercise. J Appl Physiol 64: 1803-1809, 1988 – reference: 11) Calibration verification of TSI LASERFLO® BPM 403. 1986, TSI Incorporated, St. Paul. – reference: 13) 織笠長俊: 血液透析時における末梢血行諸量の変化. 岩手医誌 38: 209-223, 1986 – reference: 14) Gaehtgens P: ‘Regulation’ of capillary haemotocrit. Int J Microcirc: Clin Exp 3: 147-160, 1984 – reference: 17) Rodgers GP, Schechter AN, Noguchi CT, Klein HG, Nienhuis AW, Bonner RF: Periodic microcirculatry flow in patients with sickle-cell disease. N Eng J Med 311: 1534-1538, 1984 – reference: 10) Druce HM, Bonner RF, atow CP, Choo P, Summers RJ, Kaliner MA: Response of nasal blood flow to neurohormones as measured by laserdoppler velocimetry. J Appl Physiol: Respirat Environ Exercise Physiol 57: 1276-1283, 1984 – reference: 16) Mchedlishvili G, Varazashvili M: Hematocrit in cerebral capillaries and veins under control and ischemic conditions. J Cereb Blood Flow Metab 7: 739-744, 1987 |
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| Title | Effect of arteriovenous fistula on cutaneous microvascular circulation in hemodialysis patients |
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