Tissue Perfusion

Tissue perfusion is often confused with blood flow, but is actually a measure of the volume of blood that flows through the capillaries in a tissue. It is generally measured in milliliters of blood per 100 grams of tissue. This measurement is carried out to understand the health of a particular tissue, since impaired or reduced perfusion can indicate a medical condition which requires care.

Ineffective tissue perfusion can be mainly renal, cerebral, gastrointestinal or cardiac in nature. In layman's terms, ineffective perfusion means that the blood flow in the affected region is insufficient. When blood flow to a particular region decreases, it causes reduced nutritional supply to the cells in this region, which can be problematic if continued over a prolonged period. Altered perfusion can also cause a reduction in oxygen supply to the affected region.

Ineffective tissue perfusion sometimes takes place for a short period of time, without serious consequences, but can result in death or damage of a tissue if left untreated or undetected. When there are fluctuations in blood circulation or flow, causing altered perfusion, there are different symptoms that will manifest in various ways, depending on the region affected. Some of the possible symptoms that may be seen are as follows:

Symptoms of Poor Tissue Perfusion

Peripheral:

• Water retention (edema)
• Weak peripheral pulse
• Numbness in extremities
• Damp, cold skin
• Changes in temperature

Cerebral:

• Mood swings and irritability
• Confusion
• Lethargy
• Altered speech pattern
• Slow or reduced pupil reaction to light

Renal:

• Low urine output
• Fluctuations in blood pressure
• High levels of blood urea nitrogen/creatinine ratio

Gastrointestinal:

• Nausea
• Abdominal pain
• Distended abdomen
• Reduction in bowel sounds

Cardiac:

• Chest pain
• Abnormal arterial blood gases
• Hypotension
• Change in rate of respiration

Treatment

Impaired tissue infusion over a prolonged period can lead to serious complications like organ failure. Depending on the affected region, the care plan for the patient will change. The care plan for each category is listed below:

Peripheral:

• Keep the patient still. Any movement may cause further trauma.
• Demonstrate, and aid in practicing passive range of motion exercises after frequent intervals.
• Monitor pulses regularly.
• Do not elevate limbs.
• Keep hands and feet warm.

Cerebral:

• In case intracranial pressure increases, raising the head of the bed to a 30 or 45 degree angle can help reduce pressure.
• Avoid any strenuous action that may cause further increase in intracranial pressure.
• Treatments may include the administration of anticonvulsants to counter the possibility of seizures.

Cardiac:

• Administer oxygen if needed.
• Administer nitroglycerin for complaints of angina.

The aim behind the treatment is to regain optimum tissue perfusion as a result of the care plan. Since any alterations in perfusion results in reduced oxygen or nutrition to the affected area, it's important to advise patients at risk about ways to prevent or reduce recurrence. Some of these ways discussed below can be incorporated into a home care plan that can be implemented through simple lifestyle changes:

• Regular low intensity exercise, such as walking
• Avoiding extreme fatigue
• Avoiding long periods of non movement, especially during long distance travel
• Sufficient hydration
• Cessation of smoking

With changes in lifestyle and medical care, ineffective tissue perfusion can be tackled before it reaches a critical stage. Always consult a medical practitioner for a correct diagnosis, and proper medical treatment.