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PubMed1989

[Comparison of humeral blood flow during rewarming and recooling of the hand in normal subjects or presenting Raynaud's phenomenon].

Vascular reactivity to heat and cold was studied in 11 normal subjects without vascular disease and in 23 patients with Raynaud's phenomenon (etiologies: Raynaud's disease, scleroderma, thoracic outlet syndrome). The study of hand and digital temperatures and brachial artery blood flow was performed in ambiant conditions (room temperature 23.5 +/- 1 degree C) and after thermal (cold or warm exposure: 10, 33 and 40 degrees C), mechanical and metabolic modifications (with a wrist tourniquet). In these conditions, blood flow was studied at each temperature, before, during and after 3 minutes ischemia of the hand. Analysis of results showed that vasomotricity possibilities were preserved but that responses were not identical. Patients with primary Raynaud's phenomenon, and even more those with scleroderma as well, had reduced brachial artery blood flow after cooling (10 degrees C). After ischemia, maximal blood flow was also reduced. The microcirculatory disease existing in Raynaud's phenomenon limits the vasodilator capacity of hand vessels, but probably more in tissues with vascular lesions. Vasodilation seems to be limited during exposure to low well as high temperatures, but vasoconstriction capacity is not disturbed.

Adult↗
PubMed1988

Rewarming and cardiac surgery: a review.

Patients undergoing cardiac surgery are mildly hypothermic by the completion of the surgical procedure. They need to return to a normothermic state if enzymatic functions are to proceed in their normal manner. The body can produce heat by elevating metabolic rate or by activating the shivering mechanism. Metabolic rate peaks shortly after separation of the patient from cardiopulmonary bypass, and therefore contributes to heat production. Because of the effects of neuromuscular blockage administered both during and after surgery; these patients may be unable to generate heat by shivering, and shivering is usually undesirable. This eliminates the major heat production mechanism available to the body. Therefore, heat must be transferred down its gradient by means of convection and conduction. External and internal methods accomplish these goals. External methods, which minimize additional heat loss, include the use of warming lights, elevation of room temperature, and the use of blankets. Internal methods, which transfer heat by convection, may be used to help actively reverse hypothermia. Such techniques include warmed inhalation gases and intravenous fluids, warmed nasogastric lavage fluid, and warmed peritoneal dialysis fluid for patients with end-stage renal failure with severe electrolyte disorders after surgery.

Body Temperature Regulation↗
PubMed1986

[Digital blood flow measurement by venous occlusion plethysmography in Raynaud's phenomenon. Value of the rewarming test].

The fingertip blood flow measured by mercury strain gauge plethysmography with venous occlusion, at 22 degrees C room temperature, had significantly lower mean values in 190 patients with Raynaud's phenomenon (55 men aged 49 yrs +/- 16, 135 women aged 48 yrs +/- 16) than in 40 age and sex matched controls: 18 ml/100 ml/minute +/- 14.6 versus 35 ml/100 ml/minute +/- 15 at level p less than 0.01. The mean fingertip blood flow was significantly lower (p less than 0.01) in 31 cases of scleroderma and 32 cases of pulpar necrosis (respectively 13 ml +/- 13 and 11 ml +/- 8) than in 55 cases of primary Raynaud's disease (no detectable etiology and normal capillaroscopy 5 years after onset) or in 34 cases of mild Raynaud's phenomenon (respectively 21.6 +/- 16 and 24.4 +/- 18). A warming test (both hands in water at 45 degrees C during 3 minutes) was performed in 50 cases with low basal fingertip blood flow. It induced a "normalized" flow in 22 cases (mostly primary or mild Raynaud), a partly improved flow in 20 cases (mostly secondary Raynaud) and no improvement in 8 cases (scleroderma). The warming test appears to be clinically useful to assess the vasospasm and the vasodilating capabilities.

Adult↗