Skin blood flow influences near-infrared spectroscopy-derived measurements of tissue oxygenation during heat stress

1 Institute for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas and Departments of 2 Health Care Sciences and 3 Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas Submitted 18 July 2005 ; accepted in final form 2 September 2005 Near-infrared (NIR) spectroscopy is a noninvasive optical technique that is increasingly used to assess muscle oxygenation during exercise with the assumption that the contribution of skin blood flow to the NIR signal is minor or nonexistent. We tested this assumption in humans by monitoring forearm tissue oxygenation during selective cutaneous vasodilation induced by locally applied heat ( n = 6) or indirect whole body heating (i.e., heating subject but not area surrounding NIR probes; n = 8). Neither perturbation has been shown to cause a measurable change in muscle blood flow or metabolism. Local heating ( 41°C) caused large increases in the NIR-derived tissue oxygenation signal [before heating = 0.82 ± 0.89 optical density (OD), after heating = 18.21 ± 2.44 OD; P < 0.001]. Similarly, whole body heating (increase internal temperature 0.9°C) also caused large increases in the tissue oxygenation signal (before heating = –0.31 ± 1.47 OD, after heating = 12.48 ± 1.82 OD; P < 0.001). These increases in the tissue oxygenation signal were closely correlated with increases in skin blood flow during both local heating (mean r = 0.95 ± 0.02) and whole body heating (mean r = 0.89 ± 0.04). These data suggest that the contribution of skin blood flow to NIR measurements of tissue oxygenation can be significant, potentially confounding interpretation of the NIR-derived signal during conditions where both skin and muscle blood flows are elevated concomitantly (e.g., high-intensity and/or prolonged exercise). heating; skin temperature Address for reprint requests and other correspondence: C. G. Crandall, Institute for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas, 7232 Greenville Ave., Suite 435, Dallas, TX 75231 (e-mail: CraigCrandall{at}texashealth.org )