Measurements of transcutaneous oxygen pressure and changes in blood rheology as markers of prognosis of critically ischemic limb in diabetes mellitus patients.
The aims of this study were to compare variations of the transcutaneous oxygen pressure (TcPO(2)) and blood rheology in diabetic patients. Diabetic patients with critical limb ischemia were compared with those who were either asymptomatic or had mild peripheral vascular disease (PVD). The results showed a significant decrease in TcPO(2) in patients with critical limb ischemia. Low shear rate blood viscosity, red blood cell (RBC) aggregation, plasma viscosity, and fibrinogen level were significantly higher in the group with critical severe limb ischemia. The group with critical limb ischemia was subdivided on the basis of clinical outcomes after 1 year and the prognostic values of these measurements examined. A TcPO(2) value of 10 mm Hg was associated with a positive predictive value of 94%. RBC aggregation index and fibrinogen levels offered positive predictive values of 89% and 88%, respectively, when cut off values were derived from means + 1 SD of same parameters in patients with asymptomatic or mild PVD. TcPO(2) is useful to follow the deterioration of diabetics with critical limb ischemia.
Khodabandehlou
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T
Hospital of Nevers, Unité de Recherche d'Hémorhéologie Clinique et de Microcirculation, France. tkhoda@wanadoo.fr
Vimeux
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M
Le Dévéhat
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C