title: Near-infrared spectroscopy of the thenar eminence to estimate forearm blood flow.
abstract: BACKGROUND
  Near-infrared spectroscopy of the thenar eminence (NIRSth) can be used at the bedside to assess tissue oxygenation (StO2), the reperfusion response to ischaemia and the tissue haemoglobin index (THI). Its ability to estimate forearm blood flow (FBF) has not previously been assessed.
  
  
  OBJECTIVE
  We aimed to test whether short-lived venous occlusion-induced changes in NIRSth-derived THI (ΔTHI/ minute) correlate with strain gauge plethysmography (SGP) measurements.
  
  
  METHODS
  We measured FBF in nine volunteers with SGP by venous occlusion, while estimating ΔTHI. Measurements were obtained in two forearm positions (elevated and horizontal) at baseline and during induced hyperaemia.
  
  
  RESULTS
  We performed 246 paired measurements at rest and after occlusion-induced hyperaemia. At rest, mean SGP-estimated FBF was 3.5-3.6 mL/dL/minute at baseline, compared with 12.9-13.6 mL/dL/minute during hyperaemia. At rest, ΔTHI was 6.1-8.2/minute, compared with 29.7-32.5/minute during hyperaemia. ΔTHI was a significant predictor of SGP FBF (P < 0.01), with stronger correlation during hyperaemia (P < 0.01). An equation was developed to convert ΔTHI/minute into FBF at mL/dL/minute (FBF = 0.362 ΔTHI/minute + 0.864).
  
  
  CONCLUSIONS
  NIRSth can be used to estimate FBF. Given its portability and its ability to also measure StO2 and vascular reactivity, NIRSth can assist in providing a comprehensive bedside assessment of the forearm circulation in critically ill patients.
authors.affiliation: Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia. rinaldo.bellomo@austin.org.au.
authors.forename: Nicholas C Z
authors.initials: NC
authors.lastname: Woinarski
authors.forename: Satoshi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Miklos
authors.initials: M
authors.lastname: Lipcsey
authors.forename: Natalie
authors.initials: N
authors.lastname: Lumsden
authors.forename: Jaye
authors.initials: J
authors.lastname: Chin-Dusting
authors.forename: Antoine G
authors.initials: AG
authors.lastname: Schneider
authors.forename: Michael
authors.initials: M
authors.lastname: Bailey
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Bellomo
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis*; D008297:Male; D010991:Plethysmography; D012039:Regional Blood Flow; D019265:Spectroscopy, Near-Infrared; D055815:Young Adult
chemical_list: D006454:Hemoglobins