Inferior mesenteric venous sampling to detect colonic ischemia: A comparison withlaser Doppler flowmetry and photoplethysmography

Anthony J. Avino, W. Andrew Oldenburg, Peter Gloviczki, Virginia M. Miller, Lawrence J. Burgart, Elizabeth J. Atkinson

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

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.).

Original languageEnglish (US)
Pages (from-to)271-279
Number of pages9
JournalJournal of vascular surgery
Volume22
Issue number3
DOIs
StatePublished - Sep 1995

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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