Non-invasive measurement of limb and digit blood flow

There are many clinical applications for non-invasive measurements of limb and digit blood flow, but often plethysmographs are inconvenient to use. Most experimental work has been carried out on patients with vascular disease. The variation of blood flow with various environmental and physiological factors has been investigated. Little information is available on the effects of injury or surgical trauma on blood flow in limbs. Plethysmographic methods measure arterial flow or pulse volume by several techniques including volumetric displacement, electrical impedance, gravimetry and the mercury in rubber strain gauge. Calorimetric, Doppler and isotope clearance techniques have also been applied to the measurement of blood flow in digits. None of these methods fulfils all the criteria for the requirements of an ideal device and some are too complicated, uncomfortable or cumbersome for widespread use. The results from different techniques are compared and the reasons for variability are discussed. Possible mechanisms for the effects of trauma on limb blood flow are suggested. Experimental comparisons of different plethysmographs are described and the requirements for future development of these devices are defined.