Caracterização da função vascular periférica pela resposta hemodinâmica da alteração postural passiva do membro inferior
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Data
2006
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Edições Universitárias Lusófonas
Resumo
O estudo da função vascular periférica tem beneficiado do desenvolvimento de diversas técnicas e metodologias de avaliação o as quais permitem caracterizar a função com um mínimo de invasibilidade. O estudo do significado de diversas variáveis transcutâneas tem ajudado a melhor compreender as complexas relações que regem a perfusão dos tecidos in vivo. No presente estudo procurámos avaliar o perfil de resposta de um grupo de indivíduos saudáveis jovens de ambos os sexos (n=23, 22,4 ± 2,2 anos), a uma manobra dinâmica (provocação) envolvendo a variação postural passiva do membro inferior (A: elevação da perna e B: decúbito dorsal) de modo a caracterizar a função vascular periférica por meio de variáveis transcutâneas (tc). A perfusão local medida por Fluxometria
de Laser Doppler (LDF) , a Perda Trans-epidérmica de água (PTEA) as pressões parciais de oxigénio
e dióxido de carbono transcutâneos e a oximetria de pulso foram escolhidas e, um intervalo de confiança de 95% adoptado.
LDF, PTEA e tcpO 2 são, manifestamente, as variáveis que melhor permitem seguir o processo em cada fase experimental. Em A foram registadas, durante a provocação, diferenças significativas na perfusão sanguínea e na pressão transcutânea de oxigénio e PTEA, especialmente nas mulheres, enquanto que o perfil de resposta obtido em B foi idêntico em ambos os grupos e comparável B hiperémia reactiva. Qualquer dos protocolos permitiu evidenciar uma relação inversamente recíproca entre a PTEA e o LD. Os resultados obtidos confirmam a utilidade destas metodologias na avaliação da função vascular periférica, confirmando as relações entre PTEA e LDF as quais devem ser adequadamente aprofundadas.
The study of the peripheral vascular function benefits from the development of several evaluation techniques and methodologies which allow for the characterization of the function without invasion of the tissue. The study of the meaning of several transcutaneous variables has helped to understand the complex relationships that rule the perfusion of the tissues in vivo. In the present study, we attempted to evaluate the profile of response of a group of healthy young individuals from both genders (n=23, 22,4 ± 2,2 years), to a dynamic maneuver (provocation) involving the postural passive change of the inferior member (A: elevation of the leg and B: dorsal decubitus), to perform the characterization of the peripheral vascular function through transcutaneous variables (tc). The local perfusion, measured by Laser Doppler flowmetry (LDF), the Trans Epidermal Water Loss (TEWL), the transcutaneous partial pressures of oxygen and carbon and the pulse oximetry were chosen and a confidence interval of 95% was adopted. LDF, TEWL and tcpO2 are, clearly, the variables that allow for a better follow up of the process in each experimental phase. In A, during the provocation, significant differences in the blood perfusion and in the oxygen transcutaneous pressure and TEWL were registered, especially in women. The profile response obtained in B was identical in both groups and comparable to the reactive hyperemia. Any of the protocols allowed to evidence an inversely reciprocal relationship between TEWL and LDF. The obtained results confirm the usefulness of these methodologies in the evaluation of the peripheral vascular function, confirming the relationships between TEWL and LDF, which should be appropriately studied.
The study of the peripheral vascular function benefits from the development of several evaluation techniques and methodologies which allow for the characterization of the function without invasion of the tissue. The study of the meaning of several transcutaneous variables has helped to understand the complex relationships that rule the perfusion of the tissues in vivo. In the present study, we attempted to evaluate the profile of response of a group of healthy young individuals from both genders (n=23, 22,4 ± 2,2 years), to a dynamic maneuver (provocation) involving the postural passive change of the inferior member (A: elevation of the leg and B: dorsal decubitus), to perform the characterization of the peripheral vascular function through transcutaneous variables (tc). The local perfusion, measured by Laser Doppler flowmetry (LDF), the Trans Epidermal Water Loss (TEWL), the transcutaneous partial pressures of oxygen and carbon and the pulse oximetry were chosen and a confidence interval of 95% was adopted. LDF, TEWL and tcpO2 are, clearly, the variables that allow for a better follow up of the process in each experimental phase. In A, during the provocation, significant differences in the blood perfusion and in the oxygen transcutaneous pressure and TEWL were registered, especially in women. The profile response obtained in B was identical in both groups and comparable to the reactive hyperemia. Any of the protocols allowed to evidence an inversely reciprocal relationship between TEWL and LDF. The obtained results confirm the usefulness of these methodologies in the evaluation of the peripheral vascular function, confirming the relationships between TEWL and LDF, which should be appropriately studied.
Descrição
Revista Lusófona de Ciências e Tecnologias da Saúde
Palavras-chave
MEDICINA, SISTEMA CARDIOVASCULAR, CIRCULAÇÃO SANGUÍNEA, MEMBROS INFERIORES, ESTUDOS DE CASO, MEDICINE, CARDIOVASCULAR SYSTEM, CASE STUDIES, LOWER EXTREMITY, BLOOD CIRCULATION