The usefulness of a laser Doppler in the measurement of toe blood pressures.
OBJECTIVE
The purpose of this study was to evaluate the clinical value and reproducibility of laser Doppler (LD) versus photoplethysmography (PPG) in the measurement of the systolic toe blood pressure.


METHODS
Toe blood pressure was measured in 60 patients in different stages of peripheral vascular disease with simultaneous digital sampling of PPG and two LD signals, each with a different filter setting (3 second [LD(3)] and 0.03 second [LD(0.03)]), and cuff pressure. These measurements were repeated after 1 week. The signals were analyzed with previous results ignored. The agreement of the PPG and LD pressures and reproducibility after 1 week were assessed by calculating the intraclass correlation coefficient (ICC). The agreement variation across the range of pressure values was visually explored by means of difference plots.


RESULTS
In 19 legs with a very low pressure only LD could adequately measure the pressure, whereas PPG did not. The ICCs between PPG and LD(3) and LD(0.03) were 0.95 or more. The ICCs of the 1-week reproducibility of the PPG, LD(3), and LD(0.03) pressures were 0.92, 0.88, and 0.86, respectively. The variation was equally distributed across the range of pressures in all three methods.


CONCLUSIONS
LD is a reliable alternative to PPG to measure toe blood pressures. Furthermore, LD is able to measure low pressures, which is relevant in the assessment of the presence of critical ischemia.
de Graaff
J C
JC
Department of Vascular Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Ubbink
D T
DT
Legemate
D A
DA
de Haan
R J
RJ
Jacobs
M J
MJ
D000368:Aged; D001795:Blood Pressure Determination / Q000379:methods*; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000503:physiopathology; D017156:Photoplethysmography; D015203:Reproducibility of Results; D012307:Risk Factors; D013997:Time Factors; D014034:Toes / Q000098:blood supply*