Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ARM”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed2002

Computer-assisted analysis helps detect inner dynein arm abnormalities.

The diagnosis of primary ciliary dyskinesia is based on demonstration of ciliary defects, mainly concerning dynein arms. Whereas the absence of outer dynein arms can be easily distinguished, the absence of inner dynein arms is difficult to confirm because of their low contrast on electron microscopy. Ciliary ultrastructure was studied in 40 patients suffering from respiratory tract infections. Conventional transmission electron microscopy showed normal cilia in 6 patients, confirmed a diagnosis of primary ciliary dyskinesia in 26 patients, and was inconclusive in 8 patients. All doubtful cases were related to inner dynein arm determination. Conventional electron microscopic analysis was able to define the ultrastructural phenotype of inner dynein arms in 40.5% of cases (6 presence of inner dynein arms, 13 absence of inner dynein arms). We developed computer-assisted analysis of electron microscopic micrographs to improve inner dynein arm visualization. Computer-assisted analysis consisted of image transformations designed to enhance the signal/noise ratio, based on the symmetry of ciliary axonemes. The sensitivity and specificity of computer-assisted analysis were 100 and 98%, respectively. The efficiency of computer-assisted analysis to visualize inner dynein arms, evaluated in the patients with undetermined phenotype after electron microscopy, was 86% (three normal cilia, seven primary ciliary dyskinesia with absence of outer dynein arms, three primary ciliary dyskinesia with absence of inner dynein arms, five partial absence of inner dynein arms). Computer-assisted analysis of ciliary micrographs improves the characterization of inherited axonemal defects.

Ciliary Motility Disorders↗
PubMed2003

Effects of trypsin-digested outer-arm dynein fragments on the velocity of microtubule sliding in elastase-digested flagellar axonemes.

Flagellar movement is caused by the coordinated activity of outer and inner dynein arms, which induces sliding between doublet microtubules. In trypsin-treated flagellar axonemes, microtubule sliding induced by ATP is faster in the presence than in the absence of the outer arms. To elucidate the mechanism by which the outer arms regulate microtubule sliding, we studied the effect of trypsin-digested outer-arm fragments on the velocity of microtubule sliding in elastase-treated axonemes of sea urchin sperm flagella. We found that microtubule sliding was significantly slower in elastase-treated axonemes than in trypsin-treated axonemes, and that this difference disappeared after the complete removal of the outer arms. After about 95% of the outer arms were removed, however, the velocity of sliding induced by elastase and ATP increased significantly by adding outer arms that had been treated with trypsin in the presence of ATP. The increase in sliding velocity did not occur in the elastase-treated axonemes from which the outer arms had been completely removed. Among the outer arm fragments obtained by trypsin treatment, a polypeptide of about 350 kDa was found to be possibly involved in the regulation of sliding velocity. These results suggest that the velocity of sliding in the axonemes with only inner arms is similar to that in the axonemes with both inner and outer arms, and that the 350 kDa fragment, probably of the alpha heavy chains, increases the sliding activity of the intact outer and inner arms on the doublet microtubules.

Animals↗
PubMed2003

The experience of therapy by therapists and survivors after exposure to armed robbery.

In this article the results of research undertaken to explore the experience of therapy by respectively the survivor of armed robbery and the therapist of the survivor of armed robbery in the case where therapy is prematurely terminated by the survivor of armed robbery are discussed. A high percentage of therapy for the survivor of armed robbery is being terminated prematurely by the survivor. This might be the reason for failing to use all possible opportunities to recover within reasonable time. The research questions that arouse are: "How do survivors of armed robbery experience therapy after being exposed to armed robbery?" and "How do therapists experience therapy for the survivor of armed robbery?" A qualitative, exploratory, descriptive and contextual research design was utilised. Phenomenological, semi-structured interviews were conducted with survivors of armed robbery and therapists of survivors of armed robbery to explore and describe their experiences. It was found that therapy leads to the experience of anger, fear, sadness and peace. The following needs of the survivor of armed robbery in the course of therapy were identified: a need to be cared for, availability, empathy, listening, focus on the armed robbery, help with the handling of problems, a trustworthy relationship with the therapist, sensitivity by the therapist and caring by important others in the life or the survivor of armed robbery. These needs were identified by both groups of participants. When these needs are not met within therapy, therapy is terminated prematurely and experienced as unsuccessful. Three principles of therapy were identified, namely that therapy should start as soon as possible, the trend and technique should be explained and signs and symptoms should be explained.

Health Personnel↗
PubMed1982

Dynein arm conformation and mechanochemical transduction in the eukaryotic flagellum.

When partially disrupted axonemes of Chlamydomonas were negatively stained in the presence of ATP, the dynein arms appeared club-shaped and were tilted proximally. In the absence of ATP, or in the presence of the non-hydrolysable ATP analogue, adenylyl imidodiphosphate, the arms on most doublets appeared to be made up of a thin diagonal component plus a larger component which resembled the arms seen in the presence of ATP but was more upright. Under these same conditions, the arms on some doublets appeared as distally directed ellipses. The two different images observed in the absence of ATP were interconvertible by tilting the doublets in a goniometer stage, indicating that they represented arms in the same conformational state viewed from two different angles. A three-dimensional model has been constructed which accounts for the appearance of the arms at the different angles. Tilting did not convert either of these images into those seen in the presence of ATP. Examination of mutants lacking the inner and outer arms indicated that all of the images were derived from the outer arm. In the absence of ATP, arms were frequently observed which were bound to a B tubule but had lost their attachment to the A tubule; such arms were not observed in the presence of ATP. These observations provide direct evidence for an ATP-dependent conformational change in the outer arm, and suggest a sequence of steps for the mechanochemical cycle of this arm.

Adenosine Triphosphatases↗
PubMed1996

A parametric model of muscle moment arm as a function of joint angle: application to the dorsiflexor muscle group in mice.

A parametric model was developed to describe the relationship between muscle moment arm and joint angle. The model was applied to the dorsiflexor muscle group in mice, for which the moment arm was determined as a function of ankle angle. The moment arm was calculated from the torque measured about the ankle upon application of a known force along the line of action of the dorsiflexor muscle group. The dependence of the dorsiflexor moment arm on ankle angle was modeled as r = R sin(a + delta), where r is the moment arm calculated from the measured torque and a is the joint angle. A least-squares curve fit yielded values for R, the maximum moment arm, and delta, the angle at which the maximum moment arm occurs as offset from 90 degrees. Parametric models were developed for two strains of mice, and no differences were found between the moment arms determined for each strain. Values for the maximum moment arm, R, for the two different strains were 0.99 and 1.14 mm, in agreement with the limited data available from the literature. While in some cases moment arm data may be better fitted by a polynomial, use of the parametric model provides a moment arm relationship with meaningful anatomical constants, allowing for the direct comparison of moment arm characteristics between different strains and species.

Animals↗
PubMed1976

[Coordination of arm movement during locomotion in Ophiuroidea].

Ophiura Amphipholis kochii Lütken can move with any one of five arms directed forwards; therefore, each arm performs various functions during locomotion. The arm amputated together with the adjoining part of the central nervous ring is capable of complicated behaviour, particularly, of locomotion. Transection of the central nervous ring results in disturbances of the arms coordination. Experiments with amputation of a part of the arms showed that afferent signals from arms are important for determination of the leading arm and mode of locomotion. The experimental data suggest that each arm has an autonomous nervous centre, and coordinated activity of all arms is acheaved by an interaction of the nervous centres. The interaction results in function distribution among the arms and in synchronization of arm movements. The leading arm prevails, since the influences exerting by its centre determine activity of adjacent centres.

Animals↗
PubMed1995

Perception of arm orientation in three-dimensional space.

The purpose of this investigation was to determine the preferred coordinate system for perception of arm (humerus) orientation in three-dimensional space. Perception of arm orientation relative to trunk-fixed versus earth-fixed axes were compared in seven human subjects. The experimenter first moved the subject's trunk and arm into a target configuration (in which the arm's orientation relative to the trunk and/or earth was perceived and memorized by the subject) and then moved the trunk and arm to a new configuration. The blindfolded subject then attempted to reproduce the target orientation of their arm relative to either the trunk (i.e., reproduce shoulder angles--intrinsic kinesthetic coordinate system) or earth-fixed axes (extrinsic kinesthetic coordinate system). Perceptual errors were similar for both shoulder (arm relative to trunk) and extrinsic (arm relative to earth) angles. However, elevation angles were perceived with greater accuracy than yaw angles in the two coordinate systems. Also, perceptual errors for arm yaw angles in the extrinsic kinesthetic coordinate system task were better predicted from changes in trunk orientation than the errors for other angles. Furthermore, four subjects matched arm yaw angle relative to the trunk-fixed axis more accurately than to the earth-fixed axis in the extrinsic coordinate system task. These results suggests a bias toward perception of yaw angles relative to trunk-fixed axes (i.e., in an intrinsic coordinate system). These data suggest that the preferred coordinate system for kinesthetic perception of arm orientation is probably fixed in the trunk.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

Intrinsic joint kinematic planning. I: reassessing the Listing's law constraint in the control of three-dimensional arm movements.

This study tested the validity of the assumption that intrinsic kinematic constraints, such as Listing's law, can account for the geometric features of three-dimensional arm movements. In principle, if the arm joints follow a Listing's constraint, the hand paths may be predicted. Four individuals performed 'extended arm', 'radial', 'frontal plane', and 'random mixed' movements to visual targets to test Listing's law assumption. Three-dimensional rotation vectors of the upper arm and forearm were calculated from three-dimensional marker data. Data fitting techniques were used to test Donders' and Listing's laws. The coefficient values obtained from fitting rotation vectors to the surfaces described by a second-order equation were analyzed. The results showed that the coefficients that represent curvature and twist of the surfaces were often not significantly different from zero, particularly not during randomly mixed and extended arm movements. These coefficients for forearm rotations were larger compared to those for the upper arm segment rotations. The mean thickness of the rotation surfaces ranged between approximately 1.7 degrees and 4.7 degrees for the rotation vectors of the upper arm segment and approximately 2.6 degrees and 7.5 degrees for those of the forearm. During frontal plane movements, forearm rotations showed large twist scores while upper arm segment rotations showed large curvatures, although the thickness of the surfaces remained low. The curvatures, but not the thicknesses of the surfaces, were larger for large versus small amplitude radial movements. In conclusion, when examining the surfaces obtained for the different movement types, the rotation vectors may lie within manifolds that are anywhere between curved or twisted manifolds. However, a two-dimensional thick surface may roughly represent a global arm constraint. Our findings suggest that Listing's law is implemented for some types of arm movement, such as pointing to targets with the extended arm and during radial reaching movements.

Adolescent↗
PubMed2004

Inertial properties of the arm are accurately predicted during motor imagery.

In the present study, using the mental chronometry paradigm, we examined the hypothesis that during motor imagery the brain uses a forward internal model of arm inertial properties to predict the motion of the arm in different dynamic states. Seven subjects performed overt and covert arm movements with one (motion around the shoulder joint) and two (motion around both the shoulder and elbow joints) degrees of freedom in the horizontal plane. Arm movements were executed under two loading conditions: without and with an added mass (4kg) attached to the subject's right wrist. Additionally, movements were performed in two different directions, condition which implies changes in the arm inertia due to the inertial anisotropy of the arm. Our analysis was focused on the timing features of overt and covert movements measured by means of an electronic stopwatch. Durations of right-direction arm movements (low inertial resistance) were smaller compared to durations of left-direction arm movements (high inertial resistance). Additionally, loading the arm with an added mass of 4kg significantly changed the dynamics of motion: movements were indeed more prolonged under loaded conditions. In both cases, the duration of simulated movements mirrored that of overtly executed movements. Therefore, neither the inertial anisotropy of the arm nor the addition of an external mass affected the timing correspondence between overt and covert movement execution. These findings suggest that the brain internally represents the inertial properties of the arm and makes use of it both for sensorimotor control and for the generation of motor images.

Acceleration↗
PubMed2007

Motor planning of arm movements is direction-dependent in the gravity field.

In the present study we analyzed kinematic and dynamic features of arm movements in order to better elucidate how the motor system integrates environmental constraints (gravity) into motor planning and control processes. To reach this aim, we experimentally manipulated the mechanical effects of gravity on the arm while maintaining arm inertia constant (i.e. the distribution of the mass around the shoulder joint). Six subjects performed single-joint arm movements (rotation around the shoulder joint) in both sagittal (upward, U, versus downward, D) and horizontal (left, L, versus right, R) planes, at different amplitudes and from different initial positions. Under these conditions, shoulder gravitational torques (SGTs) significantly varied when arm movements were performed in the sagittal but not in the horizontal plane. Contrary to SGTs, arm inertia remained constant and similar for both horizontal and sagittal planes since subjects performed arm movements with only one degree of freedom. All subjects, whatever the movement direction, appropriately scaled shoulder joint kinematic parameters according to movement amplitude. Furthermore, peak velocity and movement duration were equivalent for both horizontal and sagittal planes. Interestingly, some kinematic parameters significantly differed according to U/D but not L/R directions. Specifically, acceleration duration was greater for D than U movements, while the opposite was true for peak acceleration. Consequently, although vertical and horizontal arm movements shared a general common strategy (i.e. scaling law), the kinematic asymmetries between U and D arm movements, especially those that reflect central planning process (i.e. peak acceleration), indicated different motor intentions regarding the direction of the upcoming movement. These findings indicate that the interaction of the arm with the dynamics of the environment is internally represented during the generation of arm trajectories.

Adult↗
PubMed2002

Isometric arm counter-pressure maneuvers to abort impending vasovagal syncope.

OBJECTIVES: We hypothesized that isometric arm exercises were able to increase blood pressure (BP) during the phase of impending vasovagal syncope and allow the patient to avoid losing consciousness. BACKGROUND: Hypotension is always present during the prodromal phase of vasovagal syncope. METHODS: We evaluated the effect of handgrip (HG) and arm-tensing in 19 patients affected by tilt-induced vasovagal syncope. The study consisted of an acute single-blind, placebo-controlled, randomized, cross-over tilt-table efficacy study and a clinical follow-up feasibility study. RESULTS: In the acute tilt study, HG was administered for 2 min, starting at the time of onset of symptoms of impending syncope. In the active arm, HG caused an increase in systolic blood pressure (SBP) from 92 +/- 10 mm Hg to 105 +/- 38 mm Hg, whereas in the placebo arm SBP decreased from 91 +/- 11 mm Hg to 73 +/- 21 mm Hg (p = 0.008). Heart rate behavior was similar in the two arms. In the active arm, 63% of patients became asymptomatic, versus 11% in the control arm (p = 0.02); conversely, only 5% of patients developed syncope, versus 47% in the control arm (p = 0.01). The patients were trained to self-administer arm-tensing treatment as soon as symptoms of impending syncope occurred. During 9 +/- 3 months of follow-up, the treatment was actually performed in 95/97 episodes of impending syncope (98%) and was successful in 94/95 (99%). No patients suffered injury or other adverse morbidity related to the relapses. CONCLUSIONS: Isometric arm contraction is able to abort impending vasovagal syncope by increasing systemic BP. Arm counter-pressure maneuvers can be proposed as a new, feasible, safe, and well accepted first-line treatment for vasovagal syncope.

Adolescent↗
PubMed2000

Ambulatory blood pressure monitoring: which arm?

To determine the effects of routinely selecting the nondominant arm for ambulatory blood pressure monitoring (ABPM) on estimates of patients' blood pressure (BP) and to evaluate the practise of using manual BP from one arm and ambulatory BP from the other on the estimation of white coat effect (WCE), an observational study was conducted in 10 volunteers, exhibiting an interarm resting clinic systolic BP (SBP) difference > or =10 mm Hg. The main outcome measures were: (i) average ambulatory SBP measured on right and left arm simultaneously during 24 h, and (ii) estimate of WCE derived, by current practise, as the difference between the referral clinic BP (the higher of the manual readings from both arms) and ambulatory non-dominant arm BP, contrasted with the WCE calculated as the difference between clinic and ambulatory readings from the same arm (the arm with the higher manual readings). The supine referral clinic SBP was 16+/-6 mm Hg higher in the right compared with the left arm. Average 24 h ambulatory SBP was 6+/-7 mm Hg higher in the right arm (range +17 to -3 mm Hg), P = 0.025. Diastolic BP measurements mirrored the systolic findings. One-third of the WCE, estimated by current practise, could be attributed to inconsistency in the choice of arm for BP measurement. Thus, inconsistency in the selection of arms for BP measurement, by different techniques, may confound estimation of patients' cardiovascular morbidity risk.

Arm↗
PubMed2003

Arm position and blood pressure: a risk factor for hypertension?

The objective of this study was to re-evaluate the effect of arm position on blood pressure (BP) measurement with auscultatory and oscillometric methods including ambulatory blood pressure monitoring (ABPM). The setting was the hospital outpatient department and the subjects chosen were normotensive and hypertensive. The effect of lowering the arm from heart level on indirect systolic BP (SBP) and diastolic BP (DBP) measurement as well as the importance of supporting the horizontal arm were measured. In the sitting position, lowering the supported horizontal arm to the dependent position increased BP measured by a mercury device from 103+/-10/60+/-7 to 111+/-14/67+/-10 mmHg in normotensive subjects, a mean increase of 8/7 mmHg (P<0.01). In hypertensive subjects, a similar manoeuvre increased BP from 143+/-21/78+/-17 to 166+/-29/88+/-20 mmHg, an increase of 23/10 mmHg (P<0.01). Combined results from normotensive and hypertensive subjects demonstrate a direct and proportional association between BP (SBP and DBP) and the increase produced by arm dependency. Similar changes and associations were noted with oscillometric devices in the clinic situation. However, supporting the horizontal arm did not alter BP. Of particular interest, analysis of 13 hypertensive subjects who underwent ABPM on two occasions, once with the arm in the 'usual' position and once with the arm held horizontally for BP measurement during waking hours, demonstrated changes comparable to the other devices. The mean 12-hour BP was 154+/-19/82+/-10 mmHg during the former period and significantly decreased to 141+/-18/74+/-9 mmHg during the latter period (P<0.01). Regression analysis of the change in SBP and DBP with arm position change again demonstrated a close correlation (r(2)=0.8113 and 0.7273; P<0.001) with the artefact being larger with higher systolic and diastolic pressures. In conclusion, arm movements lead to significant artefacts in BP measurement, which are greater, the higher the systolic or diastolic pressure. These systematic errors occur when using both auscultatory and oscillometric (clinic and ABPM) devices and might lead to an erroneous diagnosis of hypertension and unnecessary medication, particularly in individuals with high normal BP levels. Since clinical interpretations of heart level vary, the horizontal arm position should be the unambiguous standard for all sitting and standing BP auscultatory and oscillometric measurements.

Adolescent↗
PubMed1999

The long-term outcome of arm function after stroke: results of a follow-up study.

PURPOSE: To assess the long-term motor and functional recovery of arm function after stroke. DESIGN: Cohort study. SUBJECTS: Fifty-four patients with a first stroke, who underwent inpatient rehabilitation, were measured early after stroke, after 16 weeks and after 4 years. MEASURES: Fugl-Meyer Motor Assessment (FM, upper extremity), Action Research Arm Test (ARA), Barthel Index, Arm Function Questionnaire, shoulder pain and range of motion, sensory function, Ashworth Scale and a perceived problem score. RESULTS: Although most of the improvement occurred during the first 16 weeks after stroke, improvement in the FM score continued after 16 weeks in 10 patients. In 13 patients the recovery of arm function only started after 16 weeks. After 4 years a fair to good recovery of arm motor function (FM score > 20) was found in 31 patients. Twenty-seven patients had fair to good functional abilities of the hemiplegic arm (ARA > 25). Submaximal ARA scores for the unaffected arm were found in 11 patients. Barthel scores > 60 were found in 52 patients. Serious shoulder pain persisted in 11 patients. Intact sensory function was found in only 14 patients. It was associated with good motor recovery (FM score > 35 in 11 patients). Loss of arm function was perceived as a major problem by 36 patients. CONCLUSION: This is the first study to investigate the recovery of arm function after stroke over a period of 4 years. It is encouraging to note that even after 16 weeks improvement still occurred in some patients. However, considerable long-term loss of arm function, associated disability and perceived problems were found. There is an obvious need to develop effective treatment methods for hemiplegic arm function.

Adolescent↗
PubMed1979

An evaluation of upper arm measurements used in nutritional assessment.

Triceps skinfold thickness and upper arm circumference (parameters used in assessing protein-calorie malnutrition) were measured on both arms of 91 adult volunteers who fulfilled criteria for absence of disease and conditions affecting nutritional status. For the total study group and subgroups of men only and women only, no significant differences were noted between right and left arm measurements of triceps skinfold thickness, arm circumference, or arm muscle circumference. Median values for significant right-left arm measurement differences were + 1.7 mm for the triceps skinfold thickness of left-handed subjects (P less than 0.05) and + 0.3 cm for the arm circumference of volunteers regularly engaged in predominately right-armed activities (P less than 0.05). Criteria of weight within 15% of "ideal" and nine serum and plasma values within a specified range were fulfilled by 77 subjects, and they comprised the "healthy" subgroup. Left arm median values for healthy men and healthy women differed from a currently accepted standard for each of three anthropometric parameters: triceps skinfold thickness (P less than 0.05), arm circumference (P less than 0.05), and arm muscle circumference (P less than 0.01).

Adult↗
PubMed1980

Sensitivity and specificity of arm circumference indicators in identifying malnourished children.

Arm circumference indicators of nutritional status such as simple arm circumference, arm circumference-for-age and arm circumference-for-height have advantages for field use because of their simplicity and low cost. However, these indicators need to be evaluated in terms of their ability to identify children who are manourished by more accepted criteria such as weight-for-age and weight-for-height. This study used sensitivity-specificity analysis to evaluate arm circumference indicators in 3838 children 1 to 4 years of age in a rural area of El Salvador. It was found that simple arm circumference gave sensitivity-specificity results similar to arm circumference-for-age and generally better than arm circumference-for-height in identifying children with low weight-for-age. The three arm circumference indicators gave similar sensitivity-specificity results in identifying children with low weight-for-height. Linear correlations of the arm circumference indicators with weight-for-age and weight-for-height gave results which correspond to the results of sensitivity-specificity analysis, but the information obtained from correlations to was less useful in evaluating the adequacy of the individual arm circumference indicators for screening purposes. Sensitivity-specificity analysis is proposed as useful method for evaluating indicators for use in nutritional surveys and for screening for malnutrition.

Aging↗
PubMed1995

Awareness of and memory for arm weakness during intracarotid sodium amytal testing.

The traditional association between anosognosia for hemiplegia and the right hemisphere was investigated in 31 patients with unilateral temporal lobe pathology during intracarotid sodium amytal testing (ISA) before epilepsy surgery. Recall of arm weakness was examined by questioning at the end of the test, when memory for items presented during the hemiplegia was also examined. Significantly more patients were amnesic for left arm weakness than for right. Amnesia for right arm weakness (and speech arrest) was significantly associated with pathology in the temporal lobe on the non-injected side and with impaired recognition of the memory items. Amnesia for left arm weakness was independent of both. Examination of cases where injection was contralateral to a hemisphere without pathology, and which showed normal memory capacity under ISA conditions, revealed that 87% recalled right arm weakness, but only 22% recalled left arm weakness. Awareness of arm weakness during left hemiplegia was examined in nine patients. Five of them were not aware of the weakness. Three of the four others could not subsequently recall it. By inference from the generally unimpaired recall of right arm weakness, following left hemisphere inactivation by amytal, an intact right hemisphere is capable of both recognizing right arm weakness and mediating its subsequent recall. In contrast, the left hemisphere was aware of left arm weakness only in approximately 50% of cases and even when there had been awareness usually could not mediate its subsequent recall. The suggestion is made that the right hemisphere may have a specific mnestic function for arm weakness, and presumably for hemiplegia, additional to the gnostic function.

Adolescent↗
PubMed2002

The threshold and gain of thermoregulatory vasoconstriction differs during anesthesia in the dependent and upper arms in the lateral position.

UNLABELLED: Increased intraluminal pressure may help maintain vasodilation in a dependent arm even after hypothermia triggers centrally mediated thermoregulatory vasoconstriction. We therefore tested the hypotheses that the threshold (triggering core temperature) and gain (increase in vasoconstriction per degree centigrade) of cold-induced vasoconstriction is reduced in the dependent arm during anesthesia. Anesthesia was maintained with 0.4 minimum alveolar anesthetic concentration of desflurane in 10 volunteers in the left-lateral position. Mean skin temperature was reduced to 31 degrees C to decrease core body temperature. Fingertip blood flow in both arms was measured, as was core body temperature. The vasoconstriction threshold was slightly, but significantly, less in the dependent arm (36.2 degrees C +/- 0.3 degrees C, mean +/- SD) than in the upper arm (36.5 degrees C +/- 0.3 degrees C). However, the gain of vasoconstriction in the dependent arm was 2.3-fold greater than in the upper arm. Consequently, intense vasoconstriction (i.e., a fingertip blood flow of 0.15 mL/min) occurred at similar core temperatures. In the lateral position, the vasoconstriction threshold was reduced in the dependent arm; however, gain was also increased in the dependent arm. The thermoregulatory system may thus recognize that hydrostatic forces reduce the vasoconstriction threshold and may compensate by sufficiently augmenting gain. IMPLICATIONS: The threshold for cold-induced vasoconstriction is reduced in the dependent arm, but the gain of vasoconstriction is increased. Consequently, the core temperature triggering intense vasoconstriction was similar in each arm, suggesting that the thermoregulatory system compensates for the hydrostatic effects of the lateral position.

Adult↗