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Assessment of microcirculation of the skin using Tissue Viability Imaging: A promising technique for detecting venous stasis in the skin

机译：使用组织生存力成像技术评估皮肤的微循环：一种检测皮肤静脉淤积的有前途的技术

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Background: : Venous occlusion in the skin is difficult to detect by existing measurement techniques. Our aim was to find out whether Tissue Viability Imaging (TiVi) was better at detecting venous occlusion by comparing it with results of laser Doppler flowmetry (LDF) during graded arterial and venous stasis in human forearm skin. Methods: : Arterial and venous occlusions were simulated in 10 healthy volunteers by inflating a blood pressure cuff around the upper right arm. Changes in the concentration of red blood cells (RBC) were measured using TiVi, while skin perfusion and concentration of moving red blood cells (CMBC) were measured using static indices of LDF during exsanguination and subsequent arterial occlusion, postocclusive reactive hyperaemia, and graded increasing and decreasing venous stasis. Results: : During arterial occlusion there was a significant reduction in the mean concentration of RBC from baseline, as well as in perfusion and CMBC (p less than 0.008). Venous occlusion resulted in a significant 28% increase in the concentration of RBC (p = 0.002), but no significant change in perfusion (mean change -14%) while CMBC decreased significantly by 24% (p = 0.02). With stepwise increasing occlusion pressures there was a significant rise in the TiVi index and reduction in perfusion (p = 0.008), while the reverse was seen when venous flow was gradually restored. Conclusion: : The concentration of RBC measured with TiVi changes rapidly and consistently during both total and partial arterial and venous occlusions, while the changes in perfusion, measured by LDF, were less consistent This suggests that TiVi could be a more useful, non-invasive clinical monitoring tool for detecting venous stasis in the skin than LDF.
机译：背景：现有的测量技术很难检测到皮肤中的静脉阻塞。我们的目的是通过与人类前臂皮肤分级动脉和静脉停滞期间的激光多普勒血流仪（LDF）结果进行比较，来发现组织活力成像（TiVi）是否更好地检测静脉阻塞。方法：通过对右上臂周围的血压袖带充气，对10名健康志愿者的动脉和静脉闭塞进行了模拟。在放血和随后的动脉闭塞，闭塞后反应性充血和分级增加期间，使用TiVi测量红细胞（RBC）浓度的变化，同时使用LDF的静态指标测量皮肤灌注和移动红细胞（CMBC）的浓度。和减少静脉淤滞。结果：在动脉闭塞期间，RBC的平均浓度与基线相比以及灌注和CMBC均显着降低（p小于0.008）。静脉阻塞导致RBC浓度显着增加28％（p = 0.002），但灌注无明显变化（平均变化-14％），而CMBC显着下降24％（p = 0.02）。随着逐步增加的阻塞压力，TiVi指数显着升高，灌注减少（p = 0.008），而当静脉血流逐渐恢复时，情况则相反。结论：：TiVi测得的红细胞浓度在全，部分动脉和静脉闭塞过程中迅速而一致地变化，而用LDF测得的灌注变化则不太一致，这表明TiVi可能是一种更有用的，非侵入性的临床检测工具比LDF检测皮肤的静脉淤滞。

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