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Impaired oxygen utilization in skeletal muscle of CRPS I patients.

Authors :
Tan EC
Ter Laak HJ
Hopman MT
van Goor H
Goris RJ
Source :
The Journal of surgical research [J Surg Res] 2012 Mar; Vol. 173 (1), pp. 145-52. Date of Electronic Publication: 2010 Sep 16.
Publication Year :
2012

Abstract

Background: The purpose of this study was to evaluate oxygen extraction and utilization in end stage chronic complex regional pain syndrome type I (CRPS I) patients undergoing amputation and to relate these to muscle histology of the amputated limb.<br />Materials and Methods: In 25 patients with severe CRPS I requiring amputation of the affected limb venous blood samples and in 11 patients skeletal muscle specimens were analyzed.<br />Results: The mean venous oxygen saturation (S(v)O(2)) value (94.3% ± 4.0%) of the affected limb was significantly higher than S(v)O(2) values found in healthy subjects (77.5% ± 9.8%) pointing to a severely decreased oxygen diffusion or utilization within the affected limb. Histologic analysis showed a significant decrease of type I fibers and a significant increase of type IIB fibers. Ultrastructural investigations of soleus skeletal muscle capillaries revealed thickened endothelial cells and thickened basement membranes. Muscle capillary densities were decreased in comparison with literature data. High venous oxygen saturation levels were partially explained by impaired diffusion of oxygen due to thickened basement membrane and decreased capillary density.<br />Conclusion: This study shows that venous oxygen saturation is significantly increased in chronic end stage CRPS I patients corresponding with impaired oxygen diffusion. The abnormal skeletal muscle findings points to severe disuse but only partially explain the impaired diffusion of oxygen; mitochondrial dysfunction seems a likely explanation in addition.<br /> (Copyright © 2012 Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1095-8673
Volume :
173
Issue :
1
Database :
MEDLINE
Journal :
The Journal of surgical research
Publication Type :
Academic Journal
Accession number :
20934715
Full Text :
https://doi.org/10.1016/j.jss.2010.08.043