Rupan Paramasivam, Nickolai Malte Kristensen, R. Ambrus, Marie Stavsetra, Mai-Britt Ørntoft, Anders Husted Madsen
{"title":"激光斑点对比成像术中评估猪模型正常和低血容量循环中的肠道微循环","authors":"Rupan Paramasivam, Nickolai Malte Kristensen, R. Ambrus, Marie Stavsetra, Mai-Britt Ørntoft, Anders Husted Madsen","doi":"10.1159/000535525","DOIUrl":null,"url":null,"abstract":"Introduction: Healing is essential for successful colorectal surgery. Optimal microcirculation is needed to ensure this; however, this is only subjectively assessed by the surgeon. Laser Speckle Contrast Imaging (LSCI) is an objective non-contact, image-based method to quantify microcirculation in bowel ends. This study aimed to evaluate the application of LSCI in an open surgery porcine model, determine differences between normal and impaired microcirculation, and test the LSCI applicability to repeated measurements.\nMethod: A midline laparotomy was made in ten healthy female pigs to expose the colon and small intestine. Subsequently, baseline measurements were conducted. A local arteria supplying the colonic or small intestine mesentery was clamped for 5 min. and LSCI measures were made again. After an hour’s rest, LSCI measurements were done in two unaffected areas on the colon and the small intestine, and baseline values were recorded. Hypotension was induced with rapid bleeding and LSCI measurements were done. After the mean arterial blood pressure (MAP) dropped to 50-60 mmHg, norepinephrine infusion was started. At a stable MAP of 85-100 mmHg, LSCI measurements were repeated at 0 min. and 30 min. during continuous norepinephrine infusion.\nResults: Cross-clamping caused LSCI levels to drop equally in both the colon and small intestine by 60% in the entire the clamped zone. Compared to baseline, the microcirculation measured by LSCI in the unclamped adjacent transition zone was diminished by 33% and 40%, colon and small intestines, respectively. During hypotension due to bleeding, LSCI decreased as expected. When MAP was stabilized by norepinephrine infusion, LSCI values dropped further: compared to baseline, measurements decreased with 24% and 20% in colon and small intestines, respectively.\nConclusion: LSCI can be used as a quantitative, real-time, non-contact method to detect changes in the microcirculation during open intestinal surgery with large changes in microcirculation due to e.g., hypovolemic and norepinephrine infusion. It is simple to use and in contrast to the existing intraoperative microcirculation assessment techniques, LSCI stands out primarily for its elimination of the requirement for a dye. As our study has shown, this feature allows us to perform time-independent measurements and repeat them indefinitely in nearby regions without compromising the effectiveness of the method.","PeriodicalId":12222,"journal":{"name":"European Surgical Research","volume":"16 1","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Laser speckle contrast imaging for intraoperative assessment of intestinal microcirculation in normo- and hypovolemic circulation in a porcine model\",\"authors\":\"Rupan Paramasivam, Nickolai Malte Kristensen, R. Ambrus, Marie Stavsetra, Mai-Britt Ørntoft, Anders Husted Madsen\",\"doi\":\"10.1159/000535525\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction: Healing is essential for successful colorectal surgery. Optimal microcirculation is needed to ensure this; however, this is only subjectively assessed by the surgeon. Laser Speckle Contrast Imaging (LSCI) is an objective non-contact, image-based method to quantify microcirculation in bowel ends. This study aimed to evaluate the application of LSCI in an open surgery porcine model, determine differences between normal and impaired microcirculation, and test the LSCI applicability to repeated measurements.\\nMethod: A midline laparotomy was made in ten healthy female pigs to expose the colon and small intestine. Subsequently, baseline measurements were conducted. A local arteria supplying the colonic or small intestine mesentery was clamped for 5 min. and LSCI measures were made again. After an hour’s rest, LSCI measurements were done in two unaffected areas on the colon and the small intestine, and baseline values were recorded. Hypotension was induced with rapid bleeding and LSCI measurements were done. After the mean arterial blood pressure (MAP) dropped to 50-60 mmHg, norepinephrine infusion was started. At a stable MAP of 85-100 mmHg, LSCI measurements were repeated at 0 min. and 30 min. during continuous norepinephrine infusion.\\nResults: Cross-clamping caused LSCI levels to drop equally in both the colon and small intestine by 60% in the entire the clamped zone. Compared to baseline, the microcirculation measured by LSCI in the unclamped adjacent transition zone was diminished by 33% and 40%, colon and small intestines, respectively. During hypotension due to bleeding, LSCI decreased as expected. When MAP was stabilized by norepinephrine infusion, LSCI values dropped further: compared to baseline, measurements decreased with 24% and 20% in colon and small intestines, respectively.\\nConclusion: LSCI can be used as a quantitative, real-time, non-contact method to detect changes in the microcirculation during open intestinal surgery with large changes in microcirculation due to e.g., hypovolemic and norepinephrine infusion. It is simple to use and in contrast to the existing intraoperative microcirculation assessment techniques, LSCI stands out primarily for its elimination of the requirement for a dye. As our study has shown, this feature allows us to perform time-independent measurements and repeat them indefinitely in nearby regions without compromising the effectiveness of the method.\",\"PeriodicalId\":12222,\"journal\":{\"name\":\"European Surgical Research\",\"volume\":\"16 1\",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2023-12-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Surgical Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000535525\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Surgical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000535525","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Laser speckle contrast imaging for intraoperative assessment of intestinal microcirculation in normo- and hypovolemic circulation in a porcine model
Introduction: Healing is essential for successful colorectal surgery. Optimal microcirculation is needed to ensure this; however, this is only subjectively assessed by the surgeon. Laser Speckle Contrast Imaging (LSCI) is an objective non-contact, image-based method to quantify microcirculation in bowel ends. This study aimed to evaluate the application of LSCI in an open surgery porcine model, determine differences between normal and impaired microcirculation, and test the LSCI applicability to repeated measurements.
Method: A midline laparotomy was made in ten healthy female pigs to expose the colon and small intestine. Subsequently, baseline measurements were conducted. A local arteria supplying the colonic or small intestine mesentery was clamped for 5 min. and LSCI measures were made again. After an hour’s rest, LSCI measurements were done in two unaffected areas on the colon and the small intestine, and baseline values were recorded. Hypotension was induced with rapid bleeding and LSCI measurements were done. After the mean arterial blood pressure (MAP) dropped to 50-60 mmHg, norepinephrine infusion was started. At a stable MAP of 85-100 mmHg, LSCI measurements were repeated at 0 min. and 30 min. during continuous norepinephrine infusion.
Results: Cross-clamping caused LSCI levels to drop equally in both the colon and small intestine by 60% in the entire the clamped zone. Compared to baseline, the microcirculation measured by LSCI in the unclamped adjacent transition zone was diminished by 33% and 40%, colon and small intestines, respectively. During hypotension due to bleeding, LSCI decreased as expected. When MAP was stabilized by norepinephrine infusion, LSCI values dropped further: compared to baseline, measurements decreased with 24% and 20% in colon and small intestines, respectively.
Conclusion: LSCI can be used as a quantitative, real-time, non-contact method to detect changes in the microcirculation during open intestinal surgery with large changes in microcirculation due to e.g., hypovolemic and norepinephrine infusion. It is simple to use and in contrast to the existing intraoperative microcirculation assessment techniques, LSCI stands out primarily for its elimination of the requirement for a dye. As our study has shown, this feature allows us to perform time-independent measurements and repeat them indefinitely in nearby regions without compromising the effectiveness of the method.
期刊介绍:
''European Surgical Research'' features original clinical and experimental papers, condensed reviews of new knowledge relevant to surgical research, and short technical notes serving the information needs of investigators in various fields of operative medicine. Coverage includes surgery, surgical pathophysiology, drug usage, and new surgical techniques. Special consideration is given to information on the use of animal models, physiological and biological methods as well as biophysical measuring and recording systems. The journal is of particular value for workers interested in pathophysiologic concepts, new techniques and in how these can be introduced into clinical work or applied when critical decisions are made concerning the use of new procedures or drugs.