Assesment of perfusion abnormalities in patients with p.o.d. using NIRS (near infrared spectroscopy)
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 8
Abstract
Peripheral arterial dissease (PAD) is a common health problem caused by reduced blood flow to the limbs. Alltough rapid development of surgery in recent years gives a modern surgical techniques, the diagnostic methods are still beeing imprecise in detecting nature of dissease – the reduction of oxygen consumption rate in skeletal muscle. Several techniques are curently beeing used to aid the diagnosis and severity assessment of patients with PAD. These include ankle-bracial index (ABI), pulse palpation, dupplex ultrasound, arteriography, computed tomography – asses blood suply but not oxygen and nutrient transport essential for limb functionality. TcpO2 and laser Doppler are used to asses blood flow fiirst of all in the surface of skin. Near infrared spectroscopy (NIRS) is a technology in which oxygen saturation of haemoglobin is measured using near infrared light. By the applying of modyfied Beer-Lambert law is possible to calculate the saturation of haemoglobin in examinated tissues. The light is emitted through muscle tissue, absorbed to a different degree, depending on the relative concentrations of oxy- and deoxyhaemoglobin. NIRS has been used since the eightees for the assesment of cerebral circulation during carotid endarterectomy in critically ill patients with sepsis, in dialised patients, in patients with claudications. This method is easily applicable and non-invasive. NIRS combined with the vascular occlusion technique is a promising approach for the evaluation of the standard duration ischaemic stimulus in patients with PAD and claudication.<br><b>Aim.</b> The aim of this study is the assesment of NIRS as a method for the evaluation of operative revascularistion.<br><b>Material and methods. </b>20 patients with PAD were studied. The occlusion test with NIRS was performed before and after the oparation. Variations in oxygenated haemoglobin (Hbo2), deoxygenated haemoglobin (Hhb), tissue oxygenation index (TOI), time of recovery and reactive hyperaemia was recorded.<br><b>Results.</b> The differences was observed in patients after and before operation. Major changes in O2Hb and Hhb and TOI were observed in patients after operation. Time of recovery was shortened in patients after operation. There were no differences in patients in reactive hyperaemia in early postoperative period.<br><b>Conclusions. </b>The occlusion NIRS test allows the evaluation of early posoperative results in patients with PAD.
Authors and Affiliations
Tomasz Krosny, Paweł Dąbek, Walerian Staszkewicz, Adam Lewszuk
Keywords
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