A study of muscle tissue oxygenation and peripheral microcirculatory dysfunction in cirrhosis using near infrared spectroscopy

Background: The circulatory dysfunction associated with cirrhosis is well described. Reduced systemic vascular resistance and high cardiac output are the main features of the hyperdynamic state, but involvement of the peripheral microcirculation in this process is poorly understood. Near infrared sp...

Full description

Saved in:
Bibliographic Details
Published in:Liver international 2010-03, Vol.30 (3), p.463-471
Main Authors: Thomson, Sam J., Cowan, Matthew L., Forton, Daniel M., Clark, Sarah J., Musa, Saif, Grounds, Michael, Rahman, Tony M.
Format: Article
Language:English
Subjects:
Adult
cirrhosis
Female
Humans
Hyperemia
Liver Cirrhosis - metabolism
Liver Cirrhosis - physiopathology
Male
Microcirculation
Middle Aged
muscle tissue oxygenation
Muscle, Skeletal - blood supply
Muscle, Skeletal - metabolism
near infrared spectroscopy
Oxygen Consumption
periphery
Spectroscopy, Near-Infrared
StO2
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: The circulatory dysfunction associated with cirrhosis is well described. Reduced systemic vascular resistance and high cardiac output are the main features of the hyperdynamic state, but involvement of the peripheral microcirculation in this process is poorly understood. Near infrared spectroscopy (NIRS) has been used to assess muscle tissue oxygenation (StO2) in haemorrhagic and septic shock. Vascular occlusion testing (VOT) can produce dynamic changes in StO2 which represent tissue oxygen extraction, delivery, and hence, surrogate markers of microvascular function. Aims: We aimed to investigate dynamic StO2 changes in the peripheral microcirculation of patients with cirrhosis. Methods: Thirty‐five subjects were examined (25 cirrhosis, 10 healthy volunteers) with an InSpectra® 650 StO2 monitor and 15 mm thenar probe. Brachial VOT was applied at systolic blood pressure +50 mmHg for 3 min, in triplicate. Dynamic StO2 parameters are reported for baseline, downslope, upslope, area over ischaemic curve, overshoot, area under recovery curve and recovery time. Results: Patients with cirrhosis demonstrated significantly larger post‐occlusive hyperaemic variables compared with volunteers: overshoot (17 vs 15%, P=0.009), area under recovery curve (25.1 vs 16.3 %/min, P
ISSN:1478-3223
1478-3231
DOI:10.1111/j.1478-3231.2009.02157.x