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  • 1
    Electronic Resource
    Electronic Resource
    Toe temperature versus transcutaneous oxygen tension monitoring during acute circulatory failure (1988)
    Springer
    Intensive care medicine 14 (1988), S. 64-68 
    Details
    ISSN: 1432-1238
    Keywords: Circulatory shock ; Transcutaneous PO2 ; Toe temperature
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Measurements of toe temperature and transcutaneous PO2 (PtcO2) have been both suggested for non-invasive assessment of peripheral blood flow in acute circulatory failure. The underlying principle of the two methods is that cutaneous vasoconstriction occurs early when tissue perfusion is altered. In 15 patients, we compared the two measurements during cardiogenic shock (27 measurements) or septic shock (29 measurements). Toe-ambiant temperature gradient and PtcO2 correlated well together (r=0.66, p(0.001) especially in hyperkinetic septic shock (r=0.79, p(0.001). In cardiogenic shock, toe-ambiant temperature correlated well with cardiac index (r=0.63), stroke index (r=0.64) and oxygen transport (r=0.65), and these correlations were stronger than for PtcO2. In septic shock, both techniques were poor indicators of blood flow indexes but PtcO2 rather correlated with arterial pressure (r=0.66) and left ventricular work (r=0.66). Trend evaluation of data revealed in cardiogenic shock that the increase in toe temperature usually preceded the increase in PtcO2. Since measurement of PtcO2 is technically more complicated, correlates less well with standard hemodynamic parameters and later reflects cardiovascular improvement, it has no advantage over measurement of toe temperature in circulatory shock. In cardiogenic shock, measurements of toe temperature can reliably track cardiac output changes. In septic states, however, non-invasive assessment of skin perfusion is of limited interest.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00254125
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  • 2
    Electronic Resource
    Electronic Resource
    Cerebral blood flow velocity responses to hypoxia in subjects who are susceptible to high-altitude pulmonary oedema (1999)
    Springer
    European journal of applied physiology 80 (1999), S. 260-263 
    Details
    ISSN: 1439-6327
    Keywords: Key words Cerebral blood flow ; Transcranial Doppler ultrasound ; Acute mountain sickness ; High-altitude pulmonary oedema ; Hypoxia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cerebral blood flow increases on exposure to high altitude, and perhaps more so in subjects who develop acute mountain sickness. We determined cerebral blood flow by transcranial Doppler ultrasound of the middle cerebral artery at sea level, in normoxia (fraction of inspired O2, F IO2 0.21), and during 15-min periods of either hypoxic (F IO2 0.125) or hyperoxic (F IO2 1.0) breathing, in 7 subjects with previous high-altitude pulmonary oedema, 6 climbers who had previously tolerated altitudes between 6000 m and 8150 m, and in 20 unselected controls. Hypoxia increased mean middle cerebral artery flow velocity from 69 (3) to 83 (4) cm · s−1 (P 〈 0.001) in the controls, from 63 (3) to 75 (3) cm · s−1 (P 〈 0.001) in the high-altitude pulmonary-oedema-susceptible subjects, and from 58 (4) to 70 (4) cm · s−1 (P 〈 0.001) in the successful high-altitude climbers. Hyperoxia decreased mean middle cerebral flow velocity to 60 (3) cm · s−1 (P 〈 0.001), 53 (3) cm · s−1 (P 〈 0.01), and 49 (3) cm · s−1 (P 〈 0.01) in the controls, high-altitude pulmonary-oedema-susceptible, and high-altitude climbers, respectively. We conclude that a transcranial Doppler-based estimate of cerebral blood flow is affected by hypoxic and hyperoxic breathing, and that it is not predictive of tolerance to high altitude.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004210050591
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Relationship of middle cerebral artery blood flow velocity to intensity during dynamic exercise in normal subjects (1993)
    Springer
    European journal of applied physiology 67 (1993), S. 35-38 
    Details
    ISSN: 1439-6327
    Keywords: Transcranial Doppler ultrasound ; Endtidal carbon dioxide tension ; Dynamic exercise ; Oxygen uptake ; Anaerobic threshold
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Cerebral blood flow has been reported to increase during dynamic exercise, but whether this occurs in proportion to the intensity remains unsettled. We measured middle cerebral artery blood flow velocity (νm) by transcranial Doppler ultrasound in 14 healthy young adults, at rest and during dynamic exercise performed on a cycle ergometer at a intensity progressively increasing, by 50 W every 4 min until exhaustion. Arterial blood pressure, heart rate, end-tidal, partial pressure of carbon dioxide (P ETCO2), oxygen uptake ( $$\dot V$$ O2) and carbon dioxide output were determined at exercise intensity. Mean vM increased from 53 (SEM 2) cm · s−1 at rest to a maximum of 75 (SEM 4) cm · s−1 at 57% of the maximal attained $$\dot V$$ O2( $$\dot V$$ O2max), and thereafter progressively decreased to 59 (SEM 4) cm · s−1 at $$\dot V$$ O2max. The respiratory exchange ratio (R) was 0.97 (SEM 0.01) at 57% of $$\dot V$$ O2maxand 1.10 (SEM 0.01) at $$\dot V$$ O2max. The P ETCO2 increased from 5.9 (SEM 0.2) kPa at rest to 7.4 (SEM 0.2) kPa at 57% of $$\dot V$$ O2maxand thereafter decreased to 5.9 (SEM 0.2) kPa at $$\dot V$$ O2max. Mean arterial pressure increased from 98 (SEM 1) mmHg (13.1 kPa) at rest to 116 (SEM 1) mmHg (15.5 kPa) at 90% of $$\dot V$$ O2max, and decreased slightly to 108 (SEM 1) mmHg (14.4 kPa) at $$\dot V$$ O2max. In all the subjects, the maximal value of v m was recorded at the highest attained exercise intensity below the anaerobic threshold (defined by R greater than 1). We concluded that cerebral blood flow as evaluated by middle cerebral artery flow velocity increased during dynamic exercise as a function of exercise intensity below the anaerobic threshold. At higher intensities, cerebral blood flow decreased, without however a complete return to baseline values, and it is suggested that this may have been at least in part explained by concomitant changes in arterial PCO2.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00377701
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    Paper (German National Licenses)
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