title: Application of intermittent negative pressure on the lower extremity and its effect on macro- and microcirculation in the foot of healthy volunteers.
abstract: Intermittent negative pressure (INP) applied to the lower leg and foot may increase peripheral circulation. However, it is not clear how different patterns of INP affect macro- and microcirculation in the foot. The aim of this study was therefore to determine the effect of different patterns of negative pressure on foot perfusion in healthy volunteers. We hypothesized that short periods with INP would elicit an increase in foot perfusion compared to no negative pressure. In 23 healthy volunteers, we continuously recorded blood flow velocity in a distal foot artery, skin blood flow, heart rate, and blood pressure during application of different patterns of negative pressure (-40 mmHg) to the lower leg. Each participant had their right leg inside an airtight chamber connected to an INP generator. After a baseline period at atmospheric pressure, we applied four different 120 sec sequences with either constant negative pressure or different INP patterns, in a randomized order. The results showed corresponding fluctuations in blood flow velocity and skin blood flow throughout the INP sequences. Blood flow velocity reached a maximum at 4 sec after the onset of negative pressure (average 44% increase above baseline, P < 0.001). Skin blood flow and skin temperature increased during all INP sequences (P < 0.001). During constant negative pressure, average blood flow velocity, skin blood flow, and skin temperature decreased (P < 0.001). In conclusion, we observed increased foot perfusion in healthy volunteers after the application of INP on the lower limb.
authors.affiliation: Section of Vascular Investigations, Division of Cardiovascular and Pulmonary Diseases, Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway Otivio AS, Gaustadalléen 21, Oslo, 0349, Norway o.h.sundby@medisin.uio.no.
authors.forename: Øyvind H
authors.initials: ØH
authors.lastname: Sundby
authors.affiliation: Section of Vascular Investigations, Division of Cardiovascular and Pulmonary Diseases, Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway Department of Anesthesiology, Oslo University Hospital, Oslo, Norway.
authors.forename: Lars Øivind
authors.initials: LØ
authors.lastname: Høiseth
authors.affiliation: Otivio AS, Gaustadalléen 21, Oslo, 0349, Norway.
authors.forename: Iacob
authors.initials: I
authors.lastname: Mathiesen
authors.affiliation: Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway.
authors.forename: Jørgen J
authors.initials: JJ
authors.lastname: Jørgensen
authors.affiliation: Oslo Center for Biostatistics and Epidemiology, Research Support Services Oslo University Hospital, Oslo, Norway.
authors.forename: Harald
authors.initials: H
authors.lastname: Weedon-Fekjær
authors.affiliation: Section of Vascular Investigations, Division of Cardiovascular and Pulmonary Diseases, Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway.
authors.forename: Jonny
authors.initials: J
authors.lastname: Hisdal
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology*; D005260:Female; D005528:Foot / Q000098:blood supply* / Q000502:physiology; D064368:Healthy Volunteers; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000295:instrumentation / Q000379:methods; D035002:Lower Extremity / Q000098:blood supply* / Q000502:physiology; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D058729:Peripheral Arterial Disease / Q000628:therapy; D011312:Pressure / Q000009:adverse effects*; D012867:Skin / Q000098:blood supply
keywords: Arterial blood flow velocity; dorsal pedis artery; intermittent negative pressure; laser doppler fluxmetry; skin blood flow