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EFFECT OF REACTIVE HYPEREMIA ON FOREARM VEIN AREA –A PILOT STUDY

Departments of Anesthesia and Radiology, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, Saskatchewan, S7N 0W8

INTRODUCTION

Reactive hyperemia is a transient increase in organ or limb blood flow following a brief period of ischemia. The purpose of this study was to determine the effect of reactive hyperemia on human forearm vein area.

METHODS

Following University of Saskatchewan Biomedical Research Ethics Board approval, twenty consenting adult subjects were studied. Exclusion criteria included: hypertension, neural or vascular limb disorders, pregnancy, and allergy to ultrasound gel. Ischemia was achieved with a tourniquet inflated on the upper arm to 200 torr, or to 25 torr for non-ischemic comparison.

All subjects received four treatments. The tourniquet was inflated on: 1) one arm to 25 torr for 2 minutes; 2) the same arm to 200 torr for 2 minutes; 3) the alternate arm to 25 torr for 5 minutes; and 4) the alternate arm to 200 torr for 5 minutes. Subjects were randomized by computer generated number table as to arm and as to order of treatment. After each treatment, serial ultrasound measurements of a predetermined forearm vein were made and recorded. A ten minute rest period preceded the next treatment.

RESULTS

Following a 2 minute ischemic period, the median vein area increased by 1.46 times compared to a non-ischemic tourniquet of 25 torr (P<0.0001), and by 1.17 times after a 5 minute ischemic period (P<0.001). After 5 minutes of ischemia, the vein area was transiently smaller prior to dilation, with the median vein area decreasing by 0.769 times (P<0.01). Order of treatment had no effect.

DISCUSSION

Numerous studies have demonstrated the effect of reactive hyperemia on the arterial system in human limbs.^1,2 However, the effect of reactive hyperemia on venous area has not been well studied.³ This study demonstrates that reactive hyperemia briefly decreases, then increases, forearm vein area. The placement of peripheral intravenous catheters may be facilitated by using reactive hyperemia to dilate the veins.

REFERENCES

1 J Cardiovasc Pharmacol. 36:640–648.

2 Am J Cardiol. 85:1071–1076.

3 J Vasc Surg. 29:1065–1070.

This article has been cited by other articles:

				H. L. Mollison, W. P.S. McKay, R. H. Patel, S. Kriegler, and O. E. Negraeff Reactive hyperemia increases forearm vein area: [L'hyperemie reactionnelle augmente l'aire veineuse de l'avant-bras]. Can J Anesth, August 1, 2006; 53(8): 759 - 763. [Abstract] [Full Text] [PDF]

This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mollison, H. L Articles by Karam, R. Search for Related Content PubMed Articles by Mollison, H. L Articles by Karam, R.