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Response of skin blood volume, velocity and flow to local warming in newborns, measured by laser Doppler flowmetry
Author(s) -
Takayanagi TOSHIMITSU,
Fukuda MASAFUMI,
Nakazawa MAKOTO,
Tanaka SHIGEKI,
Yoshinaga MUNEYOSHI
Publication year - 1999
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1046/j.1442-200x.1999.01145.x
Subject(s) - medicine , laser doppler velocimetry , gestational age , blood flow , microcirculation , blood volume , birth weight , low birth weight , anesthesia , pregnancy , biology , genetics
Background : In order to know the response of the skin microcirculation to local warming, we determined changes in the skin blood volume (Vol), velocity (Vel) and flow (F) by using a new laser Doppler device on newborns. Methods: The study subjects were 39 infants whose gestational age was 34.1~2.8 weeks and birth weight was 2189~572 g. The study was performed from 8 h postnatally to 28 postnatal days. We measured skin blood volume, velocity and flow at 36°C (Vol 36 , Vel 36 , F 36 ), and each value at 5 min (Vol 44–5 , Vel 44–5 , F 44–5 ) and 10 min (Vol 44–10 , Vel 44–10 , F 44–10 ) after local warming was applied at 44°C and the response curve of each parameter was obtained. Subsequently, serial changes in the response of skin microcirculation to local warming were investigated in nine very low birth weight (VLBW) infants (28.3~0.9 weeks, 1150~148 g) and 12 low birth weight (LBW) infants (32.8~1.3 weeks, 1971~292 g). The F 36 , the increment rate of blood volume (ΔVol) and the increment rate of blood velocity (ΔVel) were obtained within 24 h, from day 1 to day 7 and from day 8 to day 30 in both VLBW and LBW infants and from day 31 to day 60 and at more than 61 days in VLBW infants. The F 36 , ΔVol and ΔVel were compared during the study periods in VLBW and LBW infants. All results were expressed as mean~SD. Results: The results showed that F 36 /F 44–10 and F 44–5 /F 44–10 , Vol 36 /Vol 44–10 and Vol 44–5 /Vol 44‐10 , Vel 36 /Vel 44‐10 and Vel 44–5 /Vel 44–10 were 0.25~0.09 and 0.74~0.17, 0.58~0.14 and 0.94~0.08, 0.42~0.12 and 0.79~0.15, respectively. Different modes of delivery did not have a significant effect on this response. The F 36 in VLBW infants was high during the early neonatal period and gradually decreased with postnatal age. The ΔVol was low in VLBW infants during the neonatal period and gradually increased. The F 36 in VLBW 1–7 was significantly higher than in LBW 1–7 (P<0.01) and full‐term controls (P<0.001). The ΔVol in VLBW 1–7 was 0.26~0.23, which is significantly lower than in LBW 1–7 (0.57~0.17, P<0.001) and full‐term controls (0.77~0.21, P<0.001). The ΔVel in VLBW 1–7 and LBW 1–7 was significantly higher than in controls (P <0.05). Conclusions : The skin blood flow increased continuously when local warming was applied at 44°C. This high blood flow and limited potential of vasodilatation are the characteristics of the skin microcirculation in VLBW infants during the neonatal period.