Nicotine-produced heamodynamic changes in patients with ischaemia of lower limb

✍ Scribed by G. S. Makin

• Publisher: John Wiley and Sons
• Year: 1968
• Tongue: English
• Weight: 277 KB
• Volume: 55
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800550809

✦ Synopsis

IT is generally assumed that cigarette smoking has a deleterious effect on blood-flow in the ischaemic limb, and patients whose limbs are so afflicted are usually advised to stop smoking. However, no objective evidence is available to support such an assumption.

The early work on the influence of nicotine on cutaneous blood-flow has been reviewed by Rottenstein, Pierce, RUSS, Felder, and Montgomery (1960). These workers studied the changes in muscle bloodflow produced by nicotine in normal subjects and found that it was increased. Further examination of their data shows a concomitant fall in resistance.

Work on nicotine-induced changes in blood-flow in ischaemic limbs is scanty. Maddock and Coller (1937) studied I patient with a 'peripheral vascular disturbance'. Coffman and Javett (1963) included in their series 6 patients with atherosclerosis and found no change in total blood-flow through the limb after cigarette smoking.

The following investigation was planned to study the acute effects of an intravenous injection of nicotine-the vaso-active component of cigarette smoke-on blood-flow in the muscles of the ischaemic limb. Smoking itself was not studied because it requires deep breathing and this causes circulatory changes (Abramson and Ferris, 1940).