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Ephedrine improves microcirculation in the diabetic neuropathic foot
H Wollersheim1, P M Netten, J A Lutterman
1Department of Medicine, St. Radboud University Hospital, Nijmegen, The Netherlands.
Abstract:
A diabetic patient is described who developed one-sided neuropathic ulceration. Noninvasive microvascular measurements during distant cooling and inspiratory gasp revealed signs of sympathetic denervation. The initially elevated total skin blood flow measured by laser Doppler equipment and decreased capillary perfusion as determined by transcutaneous oxygen tension measurements were both partially restored after treatment with the alpha 1-sympathicomimetic ephedrine. The improvement occurred once more after rechallenge. In conclusion this study further supports the hypothesis of a capillary steal phenomenon caused by extreme vasodilation within sympathetically denervated arteriovenous shunt vessels.