Protective skeletal muscle arteriolar vasomotion during critical perfusion conditions of osteomyocutaneous flaps is not mediated by nitric oxide and endothelins

Rücker, Martin; Strobel, Oliver; Vollmar, Brigitte; Spitzer, W.J.; Menger, Michael D.

doi:10.1007/s00423-003-0389-z

Cited by 7 publications

(7 citation statements)

References 19 publications

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“…5 illustrate how type II swings only occur at frequencies Ͻ0.04 Hz whereas the type I swings occur at a range of frequencies up to 0.32 Hz. Our understanding of the nature and origin of rhythmic fluctuations in the cardiovascular system has been advanced with the development of optical tools such as laser Doppler fluximetry (27,40) and intravital microscopy (6,35,41). These techniques have studied the spontaneous rhythmic vasodilation and vasoconstriction of blood vessels, known as vasomotion, through the measurement of oscillations in the concentration of moving red blood cells (flux) or vessel diameter, respectively.…”

Section: Discussionmentioning

confidence: 99%

Is mean blood saturation a useful marker of tissue oxygenation?

Thorn¹,

Matcher²,

Meglinski³

et al. 2009

American Journal of Physiology-Heart and Circulatory Physiology

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Thorn CE, Matcher SJ, Meglinski IV, Shore AC. Is mean blood saturation a useful marker of tissue oxygenation?. Am J Physiol Heart Circ Physiol 296: H1289 -H1295, 2009. First published March 13, 2009 doi:10.1152/ajpheart.01192.2008.-Increasingly we are monitoring the distribution of oxygen through the microcirculation using optical techniques such as optical reflectance spectroscopy (ORS) and near-infrared spectroscopy. Mean blood oxygen saturation (SmbO2) and tissue oxygenation index measured by these two techniques, respectively, evoke a concept of the measurement of oxygen delivery to tissue. This study aims to establish whether SmbO2 is an appropriate indicator of tissue oxygenation. Spontaneous fluctuations in SmbO2 observed as changes in concentration of oxyhemoglobin ([HbO2]) and deoxyhemoglobin ([Hb]) were measured by ORS in the skin microcirculation of 30 healthy subjects (15 men, age 21-42 yr). Fourier analysis identified two distinctly different spontaneous falls in SmbO2. The first type of swing, thought to be induced by fluctuations in arterial blood volume, resulted from the effects of respiration, endothelial, sympathetic, and myogenic activity. There was no apparent change in [Hb]. In contrast, a second type of swing resulted from a fall in [HbO2] accompanied by a rise in [Hb] and was only induced by endothelial and sympathetic activity. Thus the same fall in SmbO2 can be induced by two distinct responses. A "type I" swing does not suggest an inadequacy in oxygen delivery whereas a "type II" swing may indicate a change in oxygen delivery from blood to tissue. SmbO2 alone cannot therefore be accepted as a definitive marker of tissue oxygenation.optical reflectance spectroscopy; microcirculation THE EXQUISITE STRUCTURE OF the microcirculation is designed to deliver nutrients to every cell in the human body. The development over the last 30 years of noninvasive optical techniques such as optical reflectance spectroscopy (ORS) (2,18,22,33) and near-infrared spectroscopy (NIRS) (7, 23) has significantly advanced our understanding of the hemodynamics of the cutaneous (1, 20), muscle (36), cerebral (11,13,29,48), and gastrointestinal (15, 38) microcirculation. Furthermore, mean blood saturation (S mb O 2 ) and tissue oxygen index (TOI) derived by ORS and NIRS, respectively, evoke a concept that we can also measure the oxygen delivery to the tissue. These parameters are increasingly being identified as indicators of tissue hypoxia (1,3,8,15,21,28,34,47), which is a common end product of circulatory shock and a primary target for resuscitation efforts (5, 37).The primary goal of this study was to establish whether cutaneous tissue oxygen saturation (i.e., S mb O 2 ) derived by ORS is an appropriate indicator of tissue oxygenation. A further goal was to explore differences in S mb O 2 across cuta- [Hb] across all the vessels of the microcirculation of the skin. Therefore the derived S mb O 2 is a mean blood oxygen saturation across arterioles, capillaries, and venules. METHODS ORS.The ORS instrumentatio...

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Section: Discussionmentioning

confidence: 99%

Is mean blood saturation a useful marker of tissue oxygenation?

Thorn¹,

Matcher²,

Meglinski³

et al. 2009

American Journal of Physiology-Heart and Circulatory Physiology

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show abstract

“…Another study demonstrated that release of NO from nitrosyl-hemoglobin complexes improved local tissue perfusion in epigastric rat flaps [4]. In contrast to these findings, a protective arteriolar vasomotion in skeletal muscle during critical perfusion of osteomyocutaneous flaps in rats was reported to occur independently of NO [5]. Additionally, nitric oxide at high concentrations has also been reported to exert cytotoxic effects by direct toxicity or by reaction with superoxide.…”

Section: Introductionmentioning

confidence: 90%

Exogenous Nitric Oxide Donation Causes Desensitization of Arteriolar Relaxing Activity In Vivo: An Intravital Analysis in Mice

Ring

Müllershausen

Goertz

et al. 2010

Journal of Surgical Research

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“…This regulatory mechanism occurs only in the striated muscle, not in the periosteum, subcutis and skin; however, it secures not only muscle microvascular perfusion, but, by redistribution of blood flow, also maintains the microvascular perfusion of those tissues which are not capable of exerting this regulatory control under critical perfusion conditions [58]. More detailed analysis revealed that arteriolar vasomotion and capillary flow motion are calcium-dependent phenomena, independent from nerve innervation [58] and not influenced by the endothelinnitric oxide balance [59]. Interestingly, the regulatory control of vasomotion and flow motion under critical flap perfusion conditions is abrogated after free flap transfer, which may be related to the ischemia-reperfusion insult [60].…”

Section: The Saphenous Artery Osteomyocutaneous Flap Modelmentioning

confidence: 95%

Experimental models to study microcirculatory dysfunction in muscle ischemia?reperfusion and osteomyocutaneous flap transfer

Menger¹,

Laschke²,

Amon³

et al. 2003

Langenbeck's Archives of Surgery

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Protective skeletal muscle arteriolar vasomotion during critical perfusion conditions of osteomyocutaneous flaps is not mediated by nitric oxide and endothelins

Abstract: Our study indicates that during critical perfusion conditions, arteriolar vasomotion develops only in muscle, not in skin, subcutis and periosteum, and that nitric oxide and endothelins are not involved in the regulation of this protective vascular response.

Cited by 7 publications

References 19 publications

Is mean blood saturation a useful marker of tissue oxygenation?

Is mean blood saturation a useful marker of tissue oxygenation?

Exogenous Nitric Oxide Donation Causes Desensitization of Arteriolar Relaxing Activity In Vivo: An Intravital Analysis in Mice

Experimental models to study microcirculatory dysfunction in muscle ischemia?reperfusion and osteomyocutaneous flap transfer

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