The microvascular responses to changes of orthostatic blood pressure differed among the three groups (normal subjects, patients with intermittent claudication, patients with critical chronic leg ischaemia). The heat washout method may be used to detect the functional significance of occlusive atherosclerotic disease.
A new method, the heat-washout method, for measuring total cutaneous blood flow rate is introduced. The measurements were performed with a transcutaneous (tc) PO2-electrode that is capable of heating and measuring local temperature, and it is constructed with a thermostatically controlled cap. The probe was heated electrically to a selected temperature 2-10 degrees above normal skin temperature. When the temperature was stable, the heating element was turned off, and the temperature was registered every 10 s until a stable baseline temperature, Tb, was obtained. Tb was subtracted from the registered temperatures giving deltaTs that were plotted in a semilogarithmic diagram. The heat-washout was monoexponential, and the slope was used for calculating blood flow rate in accordance with the principle of Kety, using a known partition coefficient. The method was applied to the forearm in two subjects, and the results were compared to blood flow rates obtained simultaneously by the 133Xe-washout method in the same area. The equation of the regression line was y = 2.5 + 0 x 968X and the correlation coefficient was 0 x 986 at temperature levels of 37-45 degrees C. In the pulp of the thumb, blood flow rates, in arteriovenous anastomoses, were estimated in two subjects by subtracting the capillary blood flow rate, measured by 133Xe-washout, from the total cutaneous blood flow rate, measured by heat-washout. Due to a relatively low diffusions coefficient for 133Xe compared to heat, 133Xe cannot be used for measurement of blood flow rate in arteriovenous anastomoses.
The disturbance of the microcirculatory responses to orthostatically induced pressure changes in claudicants reverted towards normal after arterial reconstruction.
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