Role of blood as heat source or sink in human limbs during local cooling and heating

The objective of the present study was to investigate the relative contribution of the convective heat transfer in the forearm and hand to 1) the total heat loss during partial immersion in cold water [water temperature (Tw) = 20 degrees C] and 2) the heat gained during partial immersion in warm water (Tw = 38 degrees C). The heat fluxes from the skin of the forearm and finger were continuously monitored during the 3.5-h immersion of the upper limb (forearm and hand) with 23 recalibrated heat flux transducers. The last 30 min of the partial immersion were conducted with an arterial occlusion of the forearm. The heat flux values decreased during the occlusion period at Tw = 20 degrees C and increased at Tw = 38 degrees C for all sites, plateauing only for the finger to the value of the tissue metabolic rate (124.8 +/- 29.0 W/m3 at Tw = 20 degrees C and 287.7 +/- 41.8 W/m3 at Tw = 38 degrees C). The present study shows that, at thermal steady state during partial immersion in water at 20 degrees C, the convective heat transfer between the blood and the forearm tissue is the major heat source of the tissue and accounts for 85% of the total heat loss to the environment. For the finger, however, the heat produced by the tissue metabolism and that liberated by the convective heat transfer are equivalent. At thermal steady state during partial immersion in water at 38 degrees C, the blood has the role of a heat sink, carrying away from the limb the heat gained from the environment and, to a lesser extent (25%), the metabolic and conductive heats. These results suggest that during local cold stress the convective heat transfer by the blood has a greater role than that suggested by previous studies for the forearm but a lesser role for the hand.