title: The impact of transcutaneous oxygen pressure measurement in patients with suspected critical lower limb ischemia.
abstract: BACKGROUND
  Our aims were to describe macro- and microvascular disease by the use of a combination of toe blood pressure (TBP) and transcutaneous oxygen pressure (TcPO2) measurements, and through this approach we aimed to classify lower limb ulcers. One specific aim was to evaluate whether patients with diabetes had a more pronounced disturbance of the microcirculation compared to patients without known diabetes.
  
  
  METHODS
  The study included a series of 498 patients with suspected critical lower limb ischemia. All patients were investigated with TBP and TcPO2, and the macro- and microvascular function was graded as normal, reduced or critically reduced.
  
  
  RESULTS
  Four hundred and twenty-two patients (85%) had ulcerations at the time of the examination, the same percentage in patients with (254/300) and in patients without diabetes (168/198). Dominantly microvascular disease with TcPO2 more reduced than TBP was seen in 18% (54/300) of the diabetic, and in 17% (33/198) of the non-diabetic patients. In the diabetic patients the lower limb ulcerations were as following: 44% ischemic, 47% mixed and 9% non-ischemic, respectively. In the non-diabetic patients the corresponding numbers were 38%, 52% and 10%.
  
  
  CONCLUSIONS
  By combining TBP and TcPO2 the degree of macro- and microvascular dysfunction can be evaluated, classification of lower limb ulcers will be facilitated and the risk of underestimation of the degree of distal ischemia will be reduced. Microvascular dysfunction is as common in non-diabetic patients, as it is in patients with diabetes.
authors.affiliation: Department of Clinical Physiology, Södersjukhuset, Stockholm, Sweden - stefan.rosfors@sodersjukhuset.se.
authors.forename: Stefan
authors.initials: S
authors.lastname: Rosfors
authors.forename: Leila
authors.initials: L
authors.lastname: Kanni
authors.forename: Thomas
authors.initials: T
authors.lastname: Nyström
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001785:Blood Gas Monitoring, Transcutaneous; D001794:Blood Pressure; D001795:Blood Pressure Determination; D016638:Critical Illness; D003925:Diabetic Angiopathies / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D007871:Leg Ulcer / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D058729:Peripheral Arterial Disease / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010100:Oxygen