TY - JOUR
T1 - Inferior mesenteric venous sampling to detect colonic ischemia
T2 - A comparison withlaser Doppler flowmetry and photoplethysmography
AU - Avino, Anthony J.
AU - Oldenburg, W. Andrew
AU - Gloviczki, Peter
AU - Miller, Virginia M.
AU - Burgart, Lawrence J.
AU - Atkinson, Elizabeth J.
N1 - Funding Information:
Funding for this project was obtained from a grant provided by the Mayo Clinic and Mayo Foundation.
PY - 1995/9
Y1 - 1995/9
N2 - Purpose: No single method has been identified that accurately and reliably detects patients with impending bowel infarction during aortic reconstruction. Serial sampling of blood gas from the inferior mesenteric vein (IMV) for detecting colonic ischemia was compared with two previously described techniques: laser Doppler flowmetry (LDF) and photoplethysmography. Methods: Nine dogs underwent induced partial colonic ischemia followed by complete ischemia. Serial IMV blood gas measurements were obtained at four intervals: baseline, partial ischemia, complete ischemia, and reperfusion. Simultaneous direct colon wall LDF and PPG measurements also were obtained. Results: Changes in pH, Po2, O2 saturation, and Pco2 demonstrated progressive acidosis, hypoxemia, and hypercapnia in association with progressive arterial occlusion and a reversal of these trends toward baseline after restoration of flow. The absence of a pulsatile photoplethysmography tracing and oxygen saturation less than 90% were predictive of altered perfusion but could not differentiate partial from complete ischemia. Although the differences in mean LDF values were statistically different during ischemia and reperfusion, there was considerable variability between each measurement. Conclusions: Analysis of blood gas from the IMV and pulse oximetry are useful techniques for detecting colonic ischemia, but only the former can distinguish partial from complete ischemia. The variability in colonic measurements with LDF limits its usefulness for detecting levels of colonic perfusion. (J VASC SURG 1995;22:271-9.).
AB - Purpose: No single method has been identified that accurately and reliably detects patients with impending bowel infarction during aortic reconstruction. Serial sampling of blood gas from the inferior mesenteric vein (IMV) for detecting colonic ischemia was compared with two previously described techniques: laser Doppler flowmetry (LDF) and photoplethysmography. Methods: Nine dogs underwent induced partial colonic ischemia followed by complete ischemia. Serial IMV blood gas measurements were obtained at four intervals: baseline, partial ischemia, complete ischemia, and reperfusion. Simultaneous direct colon wall LDF and PPG measurements also were obtained. Results: Changes in pH, Po2, O2 saturation, and Pco2 demonstrated progressive acidosis, hypoxemia, and hypercapnia in association with progressive arterial occlusion and a reversal of these trends toward baseline after restoration of flow. The absence of a pulsatile photoplethysmography tracing and oxygen saturation less than 90% were predictive of altered perfusion but could not differentiate partial from complete ischemia. Although the differences in mean LDF values were statistically different during ischemia and reperfusion, there was considerable variability between each measurement. Conclusions: Analysis of blood gas from the IMV and pulse oximetry are useful techniques for detecting colonic ischemia, but only the former can distinguish partial from complete ischemia. The variability in colonic measurements with LDF limits its usefulness for detecting levels of colonic perfusion. (J VASC SURG 1995;22:271-9.).
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U2 - 10.1016/S0741-5214(95)70141-9
DO - 10.1016/S0741-5214(95)70141-9
M3 - Article
C2 - 7674470
AN - SCOPUS:0029127732
SN - 0741-5214
VL - 22
SP - 271
EP - 279
JO - Journal of vascular surgery
JF - Journal of vascular surgery
IS - 3
ER -