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Updated: May 11, 2026
Near-Infrared Spectroscopy During Reactive Hyperemia for the Assessment of Lower Limb Vascular Function
Published on: March 22, 2024
A novel technique for the assessment of preoperative cardiovascular risk: reactive hyperemic response to short-term
Robert Schier1, Jochen Hinkelbein, Hanke Marcus
1Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany. robert.schier@gmx.net
Background:
Perioperative vascular function has been widely studied using noninvasive techniques that measure reactive hyperemia as a surrogate marker of vascular function. However, studies are limited to a static setting with patients tested at rest. We hypothesized that exercise would increase reactive hyperemia as measured by digital thermal monitoring (DTM) in association to patients' cardiometabolic risk.
Methods:
Thirty patients (58 ± 9 years) scheduled for noncardiac surgery were studied prospectively. Preoperatively, temperature rebound (TR) following upper arm cuff occlusion was measured before and 10 minutes after exercise. Data are presented as means ± SD. Statistical analysis utilized ANOVA and Fisher's exact test, with P values <0.05 regarded as significant.
Results:
Following exercise, TR-derived parameters increased significantly (absolute: 0.53 ± 0.95 versus 0.04 ± 0.42°C, P=0.04, and % change: 1.78 ± 3.29 versus 0.14 ± 1.27 %, P=0.03). All patients with preoperative cardiac risk factors had a change in TR (after/before exercise, ΔTR) with values falling in the lower two tertiles of the study population (ΔTR <1.1%).
Conclusion:
Exercise increased the reactive hyperemic response to ischemia. This dynamic response was blunted in patients with cardiac risk factors. The usability of this short-term effect for the preoperative assessment of endothelial function warrants further study.
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