title: Heel blood flow during loading and off-loading in bedridden older adults with low and normal ankle-brachial pressure index: a quasi-experimental study.
abstract: The purpose of this study was to evaluate the differences in heel blood flow during loading and off-loading in bedridden adults older than 65 years. The patients were divided into three groups based on ankle-brachial pressure index (ABI) and transcutaneous oxygen tension (tcPO₂): (1) patients with an ABI ≥ 0.8 (Group A); (2) patients with an ABI < 0.8 and heel tcPO₂ ≥ 10 mmHg (Group B); and (3) patients with an ABI < 0.8 and heel tcPO₂ < 10 mmHg (Group C). Heel blood flow was monitored using tcPO₂ sensors. Data were collected with the heel (1) suspended above the bed surface (preload), (2) on the bed surface for 30 min (loading), and (3) again suspended above the bed surface for 60 min (off-loading). Heel blood flow during off-loading was assessed using three parameters: oxygen recovery index (ORI), total tcPO₂ for the first 10 min, and change in tcPO₂ after 60 min of off-loading. ORI in Group C (n = 8) was significantly shorter than in Groups A (n = 22) and B (n = 15). Total tcPO₂ for the first 10 min of off-loading in Group C was significantly less than that in Groups A and B. Change in tcPO₂ after 60 min of off-loading in Group C was less than in Group A. Based on these findings, additional preventive care against heel blood flow decrease in older adults with an ABI < 0.8 and heel tcPO₂ < 10 mmHg might be necessary after loading.
authors.affiliation: Department of Nursing, Kobe City Medical Center, General Hospital, Kobe City, Japan.
authors.forename: Nami
authors.initials: N
authors.lastname: Masaki
authors.forename: Junko
authors.initials: J
authors.lastname: Sugama
authors.forename: Mayumi
authors.initials: M
authors.lastname: Okuwa
authors.forename: Misako
authors.initials: M
authors.lastname: Inagaki
authors.forename: Junko
authors.initials: J
authors.lastname: Matsuo
authors.forename: Tosio
authors.initials: T
authors.lastname: Nakatani
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sanada
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D005260:Female; D006365:Heel / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D016474:Weight-Bearing
chemical_list: D010100:Oxygen