Citation

Park KH, Park WJ, Kim MK, Kim HS, Kim SH, Cho GY, Choi YJ. Crit. Care 2012; 16(1): R25.

Copyright

(Copyright © 2012, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/cc11190

PMID

22326053

Abstract

INTRODUCTION: The aim of this study was to evaluate the functional changes of the arterial endothelium and smooth muscle after a high-voltage electrical injury (HVEI), using flow-mediated dilation (FMD) and nitrate mediated dilation (NMD). METHODS: Twenty-five male patients injured in the upper extremities by current due to contact with more than 20,000 volts were enrolled in the study. FMD and NMD were measured on the brachial artery within 48 hours after HVEI, and follow-up FMD and NMD were evaluated 6 weeks later. In addition, we enrolled age, sex, and body mass index matched healthy control group consisting of 25 individuals. Including FMD and NMD, all the variables of the control group were investigated one time and compared with the initial and 6 week follow-up data of the HVEI group. RESULTS: A significantly lower initial FMD was seen in the HVEI group compared with the control group (2.1+/-1.2% vs. 13.6+/-3.4%, p<0.01). At the 6 week follow-up, the FMD of the HVEI group had significantly improved compared to the initial FMD (2.1+/-1.2% vs. 5.1+/-2.1%, p<0.01), but it was still lower than the FMD of the control group (5.1+/-2.1% vs. 13.6+/-3.4%, p<0.01). A significantly lower NMD was seen both initially and at the 6 week follow-up compared with the NMD of the control group (7.3+/-4.7% vs. 20.4+/-4.1%, p<0.01 and 11.4+/-6.7% vs. 20.4+/-4.1%, p<0.01, respectively). The FMD study of the contralateral uninjured arm from HVEI was available in six patients. In those patients, the 6 week follow-up FMD was significantly improved in the HVEI arm compared with the initial FMD (1.8+/-0.6% vs. 4.4+/-1.6%, p<0.01). However, in the contralateral uninjured arm, there was no difference between the initial and at the 6 week follow-up FMDs (5.5+/-1.4% vs. 6.9+/-2.2%, p=0.26). CONCLUSIONS: After HVEI, the endothelial and smooth muscle functions of the brachial artery were significantly decreased for at least 6 weeks. Long term cautious care might be needed for all victims of HVEI, because there is a chance of increased risk of thrombosis or stenosis in the injured arm.

Language: en