Urakov Aleksandr, Urakova Natalya, Kasatkin Anton, Samorodov Aleksandr, Pavlov Valentin
Department of General and Clinical Pharmacology, Izhevsk State Medical Academy, 426034 Izhevsk, Udmurt Republic, Russia.
Department of Modeling and Synthesis of Technological Structures, Institute of Mechanics, Udmurt Federal Research Center, 426067 Izhevsk, Udmurt Republic, Russia.
Rev Cardiovasc Med. 2022 May 13;23(5):174. doi: 10.31083/j.rcm2305174. eCollection 2022 May.
Since changes in the tone and size of the lumen of peripheral blood vessels with massive blood loss are part of the mechanism of adaptation to hypoxia, which automatically changes the flow of warm blood to the fingertips, it was assumed that infrared thermography of the fingertips can reveal the dynamics of heat release in them, reflecting the reactivity of peripheral blood vessels and adaptation to hypoxia. It was assumed that the cuff occlusion test (COT) would assess the available reserves of adaptation to hypoxia and improve the accuracy of resistance to hypoxia and the prognosis of survival in massive blood loss.
The temperature change in the fingertips before and after the application of COT in the corresponding hand was studied in healthy adult volunteers, donors after donating 400 mL of blood and in victims with blood loss of less than or more than 35%.
During COT, the temperature in the fingers of the ischemic hand decreased in all the subjects. After COT the temperature in the fingers rose above the baseline level in healthy volunteers and in donors who donated 400 mL of blood, but did not increase in most patients with massive blood loss, of which some patients died despite the treatment.
We report the dynamics of local temperature in the finger pads after the COT in healthy adult volunteers, in donors after they donated 400 mL of venous blood each, and in victims with massive blood loss less than or greater than 35%. It is shown that the detection of local hyperthermia in the finger pads after occlusion is a sign of good adaptation to hypoxia and the probability of survivability of the victim with massive blood loss.
由于大量失血时外周血管管腔张力和大小的变化是适应缺氧机制的一部分,而这会自动改变流向指尖的温血流量,因此推测指尖红外热成像可揭示其中的热量释放动态,反映外周血管反应性和对缺氧的适应性。据推测,袖带阻断试验(COT)将评估对缺氧的可用适应储备,并提高对缺氧的耐受性及大量失血时生存预后的准确性。
对健康成年志愿者、捐献400 mL血液后的献血者以及失血少于或多于35%的受害者,研究相应手部应用COT前后指尖的温度变化。
在COT期间,所有受试者缺血手手指的温度均下降。COT后,健康志愿者和捐献400 mL血液的献血者手指温度升至基线水平以上,但大多数大量失血患者的手指温度并未升高,其中一些患者尽管接受了治疗仍死亡。
我们报告了健康成年志愿者、每次捐献400 mL静脉血后的献血者以及失血少于或多于35%的大量失血受害者在COT后指腹局部温度的动态变化。结果表明,阻断后指腹局部体温升高是对缺氧良好适应的标志,也是大量失血受害者存活的可能性指标。