Perfusion
Encyclopedia
In physiology
, perfusion is the process of nutritive delivery of arterial blood
to a capillary
bed in the biological tissue
. The word is derived from the French verb "perfuser" meaning to "pour over or through."
Tests of adequate perfusion are a part of the patient assessment process performed by medical or emergency personnel. The most common methods include evaluating skin color, temperature, condition and capillary refill.
Tissues like the skin
are considered overperfused and receive more blood than would be expected to meet the metabolic needs of the tissue. In the case of the skin, extra blood flow is used for thermoregulation
. In addition to delivering oxygen
, the blood helps dissipate
heat by redirecting warm blood close to the surface where it can cool the body through sweating
and thermal radiation
.
(MRI) techniques can be used to measure tissue perfusion in vivo
.
was awarded the Nobel Prize in Physiology or Medicine
for the discovery of the mechanism of regulation of the capillaries in skeletal muscle
. Krogh was first to describe the adaptation of blood perfusion in muscle and other organs according to demands through opening and closing the arterioles and capillaries.
Physiology
Physiology is the science of the function of living systems. This includes how organisms, organ systems, organs, cells, and bio-molecules carry out the chemical or physical functions that exist in a living system. The highest honor awarded in physiology is the Nobel Prize in Physiology or...
, perfusion is the process of nutritive delivery of arterial blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
to a capillary
Capillary
Capillaries are the smallest of a body's blood vessels and are parts of the microcirculation. They are only 1 cell thick. These microvessels, measuring 5-10 μm in diameter, connect arterioles and venules, and enable the exchange of water, oxygen, carbon dioxide, and many other nutrient and waste...
bed in the biological tissue
Biological tissue
Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...
. The word is derived from the French verb "perfuser" meaning to "pour over or through."
Tests of adequate perfusion are a part of the patient assessment process performed by medical or emergency personnel. The most common methods include evaluating skin color, temperature, condition and capillary refill.
Overperfusion and underperfusion
The terms "overperfusion" and "underperfusion" are measured relative to the average level of perfusion across all tissues in an individual body, and the terms should not be confused with hypoperfusion and "hyperperfusion", which measure the perfusion level relative to the tissue's current need.Tissues like the skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
are considered overperfused and receive more blood than would be expected to meet the metabolic needs of the tissue. In the case of the skin, extra blood flow is used for thermoregulation
Thermoregulation
Thermoregulation is the ability of an organism to keep its body temperature within certain boundaries, even when the surrounding temperature is very different...
. In addition to delivering oxygen
Oxygen
Oxygen is the element with atomic number 8 and represented by the symbol O. Its name derives from the Greek roots ὀξύς and -γενής , because at the time of naming, it was mistakenly thought that all acids required oxygen in their composition...
, the blood helps dissipate
Dissipation
In physics, dissipation embodies the concept of a dynamical system where important mechanical models, such as waves or oscillations, lose energy over time, typically from friction or turbulence. The lost energy converts into heat, which raises the temperature of the system. Such systems are called...
heat by redirecting warm blood close to the surface where it can cool the body through sweating
Sweating
Perspiration is the production of a fluid consisting primarily of water as well as various dissolved solids , that is excreted by the sweat glands in the skin of mammals...
and thermal radiation
Thermal radiation
Thermal radiation is electromagnetic radiation generated by the thermal motion of charged particles in matter. All matter with a temperature greater than absolute zero emits thermal radiation....
.
Measurement using MRI
Two main categories of magnetic resonance imagingMagnetic resonance imaging
Magnetic resonance imaging , nuclear magnetic resonance imaging , or magnetic resonance tomography is a medical imaging technique used in radiology to visualize detailed internal structures...
(MRI) techniques can be used to measure tissue perfusion in vivo
In vivo
In vivo is experimentation using a whole, living organism as opposed to a partial or dead organism, or an in vitro controlled environment. Animal testing and clinical trials are two forms of in vivo research...
.
- The first is based on the use of injected contrast agent that changes the magnetic susceptibilityMagnetic susceptibilityIn electromagnetism, the magnetic susceptibility \chi_m is a dimensionless proportionality constant that indicates the degree of magnetization of a material in response to an applied magnetic field...
of blood and thereby the MR signal which is repeatedly measured during bolusBolus (medicine)In medicine, a bolus is the administration of a medication, drug or other compound that is given to raise its concentration in blood to an effective level...
passage. - The other category is based on arterial spin labeling (ASL), where arterial blood is magnetMagnetA magnet is a material or object that produces a magnetic field. This magnetic field is invisible but is responsible for the most notable property of a magnet: a force that pulls on other ferromagnetic materials, such as iron, and attracts or repels other magnets.A permanent magnet is an object...
ically tagged before it enters into the tissue of interest and the amount of labeling is measured and compared to a control recording obtained without spin labeling.
Discovery
In 1920 August KroghAugust Krogh
Schack August Steenberg Krogh FRS was a Danish professor of Romani background at the department of zoophysiology at the University of Copenhagen from 1916-1945...
was awarded the Nobel Prize in Physiology or Medicine
Nobel Prize in Physiology or Medicine
The Nobel Prize in Physiology or Medicine administered by the Nobel Foundation, is awarded once a year for outstanding discoveries in the field of life science and medicine. It is one of five Nobel Prizes established in 1895 by Swedish chemist Alfred Nobel, the inventor of dynamite, in his will...
for the discovery of the mechanism of regulation of the capillaries in skeletal muscle
Skeletal muscle
Skeletal muscle is a form of striated muscle tissue existing under control of the somatic nervous system- i.e. it is voluntarily controlled. It is one of three major muscle types, the others being cardiac and smooth muscle...
. Krogh was first to describe the adaptation of blood perfusion in muscle and other organs according to demands through opening and closing the arterioles and capillaries.