The influence of local skin heating and reactive hyperaemia on skin blood flow abnormalities in patients with reflex sympathetic dystrophy (RSD). 1995

H A Kurvers, and M J Jacobs, and R J Beuk, and F A van den Wildenberg, and P J Kitslaar, and D W Slaaf, and R S Reneman
Department of Surgery, University Hospital Maastricht, The Netherlands.

Skin blood flow in reflex sympathetic dystrophy (RSD) patients has been reported to develop from an increase at an early stage to a decrease at later stages. So far, it remains unclear whether these abnormalities are solely of microcirculatory origin, and result from functional vasospasm or structural vessel wall changes. Eighty-seven RSD patients were categorized as follows: stage I in case of a stationary warmth sensation; stage II in case of an intermittent warmth and cold sensation; and stage III in case of a stationary cold sensation. Laser Doppler flowmetry (LDF) was used as a measure of total skin blood flow and transcutaneous oximetry (TCPO2) as a measure of vascular reactivity in the more superficial skin layers. Local skin heating and reactive hyperaemia were used to study the relative reserve capacity of skin microvessels. Finapres was used to assess digital arterial pressures. As compared to healthy volunteers (n = 16), LDF under control conditions demonstrated an increase in skin blood flow at stage I (P < 0.01). A decrease in skin blood flow under control conditions was seen at stages II (P < 0.05) and III (P < 0.05), but the relative flow reserve capacity, as measured with LDF, was not impaired at these stages. Regression analysis did not show a relation between LDF parameters and duration of the syndrome. TCPO2 revealed no differences between patient groups and controls. Regression analysis did not demonstrate a relation between TCPO2 parameters and duration of the syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D008297 Male Males
D008833 Microcirculation The circulation of the BLOOD through the MICROVASCULAR NETWORK. Microvascular Blood Flow,Microvascular Circulation,Blood Flow, Microvascular,Circulation, Microvascular,Flow, Microvascular Blood,Microvascular Blood Flows,Microvascular Circulations
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012019 Reflex Sympathetic Dystrophy A syndrome characterized by severe burning pain in an extremity accompanied by sudomotor, vasomotor, and trophic changes in bone without an associated specific nerve injury. This condition is most often precipitated by trauma to soft tissue or nerve complexes. The skin over the affected region is usually erythematous and demonstrates hypersensitivity to tactile stimuli and erythema. (Adams et al., Principles of Neurology, 6th ed, p1360; Pain 1995 Oct;63(1):127-33) Algodystrophy,Complex Regional Pain Syndrome, Type I,Pain Syndrome Type I, Regional, Complex,Shoulder-Hand Syndrome,Sudek Atrophy,Algodystrophic Syndrome,CRPS Type I,Cervical Sympathetic Dystrophy,Pain Syndrome Type I, Complex Regional,RSD (Reflex Sympathetic Dystrophy),Reflex Sympathetic Dystrophy Syndrome,Sudek's Atrophy,Sympathetic Reflex Dystrophia,Syndrome, Reflex Sympathetic Dystrophy,Type I Complex Regional Pain Syndrome,Algodystrophies,Atrophies, Sudek's,Atrophy, Sudek,Atrophy, Sudek's,CRPS Type Is,Cervical Sympathetic Dystrophies,Dystrophies, Cervical Sympathetic,Dystrophies, Reflex Sympathetic,Dystrophy, Cervical Sympathetic,Dystrophy, Reflex Sympathetic,RSDs (Reflex Sympathetic Dystrophy),Reflex Dystrophia, Sympathetic,Reflex Sympathetic Dystrophies,Shoulder Hand Syndrome,Shoulder-Hand Syndromes,Sudek's Atrophies,Sudeks Atrophy,Sympathetic Dystrophies, Cervical,Sympathetic Dystrophies, Reflex,Sympathetic Dystrophy, Cervical,Sympathetic Dystrophy, Reflex,Sympathetic Reflex Dystrophias,Syndrome, Algodystrophic,Syndrome, Shoulder-Hand,Syndromes, Shoulder-Hand,Type I, CRPS
D001785 Blood Gas Monitoring, Transcutaneous The noninvasive measurement or determination of the partial pressure (tension) of oxygen and/or carbon dioxide locally in the capillaries of a tissue by the application to the skin of a special set of electrodes. These electrodes contain photoelectric sensors capable of picking up the specific wavelengths of radiation emitted by oxygenated versus reduced hemoglobin. Carbon Dioxide Partial Pressure Determination, Transcutaneous,Cutaneous Oximetry,Oximetry, Transcutaneous,Oxygen Partial Pressure Determination, Transcutaneous,Transcutaneous Blood Gas Monitoring,Transcutaneous Capnometry,Transcutaneous Oximetry,PtcO2,TcPCO2,Capnometries, Transcutaneous,Capnometry, Transcutaneous,Cutaneous Oximetries,Oximetries, Cutaneous,Oximetries, Transcutaneous,Oximetry, Cutaneous,Transcutaneous Capnometries,Transcutaneous Oximetries
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D005260 Female Females
D006358 Hot Temperature Presence of warmth or heat or a temperature notably higher than an accustomed norm. Heat,Hot Temperatures,Temperature, Hot,Temperatures, Hot
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006940 Hyperemia The presence of an increased amount of blood in a body part or an organ leading to congestion or engorgement of blood vessels. Hyperemia can be due to increase of blood flow into the area (active or arterial), or due to obstruction of outflow of blood from the area (passive or venous). Active Hyperemia,Arterial Hyperemia,Passive Hyperemia,Reactive Hyperemia,Venous Congestion,Venous Engorgement,Congestion, Venous,Engorgement, Venous,Hyperemia, Active,Hyperemia, Arterial,Hyperemia, Passive,Hyperemia, Reactive,Hyperemias,Hyperemias, Reactive,Reactive Hyperemias

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