Continuous mean arterial pressure measurement in the fingers: The influence of local arm cooling

Raamat, Rein; Jagomägi, K.; Talts, J.; Länsimies, Esko; Jurvelin, Jukka S.; Kolari, P J

doi:10.1007/bf02345150

Cited by 12 publications

(5 citation statements)

References 21 publications

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“…The microcirculatory changes which result in this condition are not fully understood (Tenland et al 1983, Lossius and Eriksen 1995, Shusterman et al 1997. It is however known that there is a relationship between falling temperature and falling peripheral blood flow (Raamat et al 2001).…”

Section: Introductionmentioning

confidence: 99%

Microvascular blood flow and skin temperature changes in the fingers following a deep inspiratory gasp

2002

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The aims of this study were to quantify the changes in finger pulp skin temperature, laser Doppler flow (LDF, microvascular flux) and photoplethysmogram (PPG, microvascular blood volume pulsatility), induced by a deep inspiration in healthy subjects, and to investigate the repeatability of these responses within a measurement session and between measurement sessions on separate days. A system comprising an electronic thermometer, a laser Doppler flowmeter and a PPG amplifier measured simultaneous vasoconstrictor responses to a deep inspiratory gasp from three adjacent fingers of one hand. Clearly defined responses were obtained in 15 of the 17 subjects studied. Skin temperature fell in all of these subjects after each gasp, with a median fall of 0.089 degrees C (P < 0.001). The median value of LDF flux reduction was 93% (P < 0.001) indicating a momentary almost complete shut-down of microvascular blood flow; and PPG also showed a large response relative to pulse amplitude of 2.6 (P < 0.001). The median times for waveforms to reach their minimum were 4.6 s (PPG), 6.3 s (LDF) and 29.1 s (skin pulp temperature), with median delays between minima of LDF and PPG of 1.6 s (P < 0.001) and skin temperature and PPG of 23.5 s (P < 0.001). The vascular responses of skin temperature, LDF and PPG to an inspiratory gasp were repeatable, with temperature change repeatable to within 10% of the median subject change.

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Section: Introductionmentioning

confidence: 99%

Microvascular blood flow and skin temperature changes in the fingers following a deep inspiratory gasp

2002

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“…It is our opinion that a reduction in k pulse during the first stage of exercise is related to spontaneous peripheral vasoconstrictions, which can be triggered by deep breathing, emotional stress or onset of physical exercise , affecting the results of blood pressure measurements in the fingers. It is well known that digital artery vasomotor tone alters by temperature (Tanaka & Thulesius, 1993), in particular by cold (Bornmyr et al, 2001;Raamat et al, 2001b), but peripheral thermoregulatory vasoconstrictions are also essential in subjects staying in the thermoneutral zone (Lossius et al, 1993). Because of severe vasoconstrictions at the beginning of the exercise we had to exclude two individual recordings from further analysis.…”

Section: Discussionmentioning

confidence: 99%

Beat‐to‐beat measurement of the finger arterial pressure pulse shape index at rest and during exercise

Raamat

Jagomägi

Talts

et al. 2003

Clin Physio Funct Imaging

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Arterial pressure waveform can be characterized by the pulse shape index kpulse determined as kpulse = (Pmean - Pdiast) / (Psyst - Pdiast). For brachial artery, the shape index value of 0.33 is usually applied to approximate Pmean from the measured Psyst and Pdiast. Our purpose was to test whether this value can validly be applied to finger vascular beds under different experimental conditions. By using Finapres, we non-invasively estimated the beat-to-beat values of kpulse in the fingers of young healthy persons in supine position at rest and during a 4-min moderate exercise (rhythmical exercise with the quadricep muscles in combination with handgrip compression). To detect intensive peripheral vasoconstrictions, a laser-Doppler probe was attached to the thumb pulp of the same hand. Periods of 30 s without intensive vasoconstriction for rest, different stages of exercise and recovery were involved in the analysis in every subject. The results demonstrated that the group-averaged value of kpulse (median with a 95% confidence interval) in the fingers of 11 healthy volunteers aged from 20 to 24, equalled 0.33 (0.31- 0.34), 0.31 (0.28-0.34), 0.35 (0.33-0.39) and 0.38 (0.34-0.43) for rest, first and second stages of exercise and recovery, respectively. We conclude that in the fingers of young healthy persons in supine position formula Pmean = Pdiast + 1/3 (Psyst - Pdiast) gives an adequate approximation for rest and low intensity exercise (first stage), and slightly underestimates the actual finger mean blood pressure during moderate exercise (second stage) and recovery.

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“…The variability introduced by the fact that the fingers are different has been shown to be no larger than the one originating from re-insertion on the same finger (Lal et al 1993) and not statistically significant. Estimating pressure in adjacent fingers with two different methods (volume-clamp versus oscillometric) has led to statistically significant differences which, however, cannot be considered clinically relevant (Raamat et al 2001). However, it is also known that measurements in adjacent fingers influence each other.…”

Section: Limitations and Extensionsmentioning

confidence: 99%

Differential response of peripheral arterial compliance-related indices to a vasoconstrictive stimulus

2008

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Peripheral arterial elastic properties are greatly affected by cardiovascular as well as other pathologies, and their assessment can provide useful diagnostic indicators. The photoplethysmographic technique can provide finger blood volume and pressure waveforms non-invasively, which can then be processed statically or beat-to-beat to characterize parameters of the vessel wall mechanics. We employ an occlusion-deflation protocol in 48 healthy volunteers to study peripheral artery compliance-related indices over positive and negative transmural pressure values as well as under the influence of a valid vasoconstrictor (cigarette smoking). We calculate beat-to-beat indices (compliance index CI, distensibility index DI, three viscoelastic model parameters (compliance C, viscosity R and inertia L), pressure-volume loop areas A and damping factor DF as well as symmetrical (C(max)) and asymmetrical (C(A)(max)) static compliance estimates, and their distributions over transmural pressure. All distributions are bell-shaped and centred on negative transmural pressure values. Distribution heights were significantly lower in the smoking group (w.r.t. the non-smoking group) for C, CI, DI and significantly higher in R and DF. The estimated volume signal time lag was also significantly lower in the smoking group. Left and right distribution widths were significantly different in all parameters/groups but DI (both groups), C(A)(max), A (smoking group) and L (non-smoking group), and positions of maxima/minima were significantly altered in C(A)(max), R and DF. C, DF and CI are seen to be most sensitive under this protocol, while C(max) and C(A)(max) are seen to be insensitive. These quantities provide complementary, time- and transmural pressure-dependent information about arterial wall mechanics, and the choice of index should depend on the physiological conditions at hand as well as relevant time resolution and transmural pressure range.

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Continuous mean arterial pressure measurement in the fingers: The influence of local arm cooling

Cited by 12 publications

References 21 publications

Microvascular blood flow and skin temperature changes in the fingers following a deep inspiratory gasp

Microvascular blood flow and skin temperature changes in the fingers following a deep inspiratory gasp

Beat‐to‐beat measurement of the finger arterial pressure pulse shape index at rest and during exercise

Differential response of peripheral arterial compliance-related indices to a vasoconstrictive stimulus

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