Jaszczak P
Department of Obstetrics and Gynaecology, Herlev University Hospital, Copenhagen, Denmark.
Dan Med Bull. 1988 Aug;35(4):322-34.
Reliable transcutaneous measurements of arterial oxygen tension are based on a maximum skin blood flow rate which is created by heating the skin, typically at an electrode temperature of 44 to 45 degrees C. This increase in skin blood flow rate creates an arterialization of the oxygen tension in the capillaries and the surrounding tissue. The heat conducted to the skin surface is removed by a combination of convection (skin perfusion) and conduction to the deeper layers of the skin. This heat transport to and through the skin surface causes a measurable temperature profile from the electrode surface to the capillary layer. By a blood flow cessation it is possible to change the temperature profile because the convective part of the heat consumption is eliminated and the conductive part can then be measured and subtracted. Using the forearm as measuring area and a heated tc-PO2 electrode several observations were made. The mean temperature gradient over epidermis down to the capillary layer at an electrode temperature of 43, 44, and 45 degrees C was 2.1, 2.4 and 2.7 degrees C, respectively. The change in temperature profile caused by the blood flow cessation enabled primarily an estimation of the skin blood flow rate by temperature measurements, ranging from 0.07 to 0.24 ml.cm-2.min-1. Increasing blood flow rates correlated to increasing tc-PO2 values. By means of a dynamically, thermally shielded tc-PO2 electrode it was possible to determine the skin blood flow rates in the same arbitrary units computed on the basis of the heat dissipation to the skin surface. Furthermore, it was possible to correlate these blood flow estimations to the cutaneous blood flow rates measured by 133Xe washout technique. By increasing the electrode temperature the cutaneous blood flow rates increased from 12 to 50 ml.(100 g)-1.min-1. It was possible to calculate a conversion factor on the basis of the correlation between the heat determinations of the skin blood flow rate and the 133Xe measurements. Using this conversion factor the highest blood flow rate did not exceed 55 ml.(100 g)-1.min-1. The subcutaneous blood flow rate increased accordingly with increasing electrode temperature. It was concluded that the measured heat consumption of the skin is effected by the heat removing capacity of the cutaneous as well as the subcutaneous blood flow. The cutaneous blood flow, however, was considered predominant in the transport of heat from the skin surface. By 50 times of stripping the skin surface, the cornified epidermal membrane was removed. This procedure increased the tc-PO2 values by on an average 3.6 kPa (27.1 mmHg).(ABSTRACT TRUNCATED AT 400 WORDS)
可靠的经皮动脉血氧分压测量基于通过加热皮肤所产生的最大皮肤血流速率,通常电极温度为44至45摄氏度。皮肤血流速率的这种增加使毛细血管和周围组织中的氧分压动脉化。传导至皮肤表面的热量通过对流(皮肤灌注)和传导至皮肤深层的组合方式被移除。这种热量向皮肤表面的传输以及通过皮肤表面的传输导致从电极表面到毛细血管层出现可测量的温度分布。通过停止血流,可以改变温度分布,因为消除了热量消耗的对流部分,然后可以测量并减去传导部分。以前臂作为测量区域并使用加热的经皮氧分压(tc-PO2)电极进行了多项观察。在电极温度为43、44和45摄氏度时,从表皮到毛细血管层的平均温度梯度分别为2.1、2.4和2.7摄氏度。血流停止引起的温度分布变化主要使得能够通过温度测量来估计皮肤血流速率,范围为0.07至0.24毫升·厘米⁻²·分钟⁻¹。血流速率增加与经皮氧分压值增加相关。借助动态热屏蔽的经皮氧分压电极,可以根据向皮肤表面的热耗散计算出相同的任意单位来确定皮肤血流速率。此外,能够将这些血流估计值与通过¹³³Xe洗脱技术测量的皮肤血流速率相关联。通过提高电极温度,皮肤血流速率从12增加到50毫升·(100克)⁻¹·分钟⁻¹。基于皮肤血流速率的热测定与¹³³Xe测量之间的相关性,可以计算出一个转换因子。使用这个转换因子,最高血流速率不超过55毫升·(100克)⁻¹·分钟⁻¹。皮下血流速率也随着电极温度升高而相应增加。得出的结论是,测量的皮肤热消耗受皮肤以及皮下血流的散热能力影响。然而,在从皮肤表面传输热量方面,皮肤血流被认为起主要作用。通过对皮肤表面进行50次剥离,去除了角质化的表皮膜。这一过程使经皮氧分压值平均增加了3.6千帕(27.1毫米汞柱)。(摘要截取自400字)