Premium
The Heated Dorsal Hand Vein: An Alternative Arterial Sampling Site
Author(s) -
Brooks David C.,
Black Preston R.,
Arcangeli Michael A.,
Aoki Thomas T.,
Wilmore Douglas W.
Publication year - 1989
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607189013001102
Subject(s) - blood flow , forearm , dorsum , arterial blood , vein , substrate (aquarium) , anatomy , artery , chemistry , blood sampling , medicine , nuclear medicine , biomedical engineering , surgery , anesthesia , biology , ecology
Studies of substrate flux, isotope activity and metabolic balance frequently require arterial sampling. We evaluated: (1) whether substrate concentrations obtained from heated dorsal hand veins (HDHV) were comparable to samples obtained from the radial artery, (2) whether heat sufficient to arterialize HDHV altered contralateral forearm blood flow thus affecting flux calculations, (3) whether a $14 heating pad equaled a cumbersome $700 heating chamber, and (4) whether HDHV showed a dose‐response curve to varying heat loads. In 12 normals, dorsal hand temperature was raised from 31.8 ± 0.6°C to 39.8 ± 0.8°C (chamber) and 39.3 ± 0.3°C (pad). Basal contralateral forearm blood flow (3.37 ± 0.7 ml/100 ml tissue/ min) was not significantly altered in the chamber (3.39 ± 0.5 ml) or the pad (3.44 ± 0.5 ml). Skin temperature of the unheated hand, an index of superficial blood flow (31.5 ± 0.7°C) did not change significantly in the chamber (31.6 ± 0.7°C) or the pad (31.2 ± 0.7°C). Forearm blood flow did not change with heating in eight postoperative patients. Comparative arterial and HDHV blood gases and 10 metabolic substrates from simultaneously drawn samples at various temperatures showed HDHV PO 2 approached but did not equal arterial PO 2 at temperatures > 39°C. Glucose, amino acid, and substrate concentrations were comparable at 39°C and did not change with increasing temperature. HDHV can reliably determine arterial substrate concentrations using an inexpensive heating pad. In cool environments (20–22°C), contralateral forearm blood flow is not significantly altered. There is no benefit to heating the hand above 39°C. (Journal of Parenteral and Enteral Nutrition 13:102–105, 1989)