Experimental model to estimate intestinal viability using charge-coupled device microscopy

Abstract

V (max) ratio and S ratio could be used as indices for evaluation of intestinal viability.

How to assess intestinal viability during surgery: A review of techniques

“…Yasumura et al performed microscopy of the serosal bowel layer and calculated the ratio of blood cell transition and the effective area of the vascular bed. These parameters were found to be useful indices for prediction of bowel survival [29] . This technique has not yet been introduced into human studies, probably because it is time consuming.…”

“…The superiority of laser Doppler flowmetry compared with ultrasound studies was shown [35] . Widely discussed limitations of this technique are that it is considered to be vulnerable to the signals from the neighboring large vessels, it requires an artery exposure and a pulsatile blood flow and a tissue contact is required which can impair local blood flow [1,29] .…”

“…The basic paradigm of hydrogen clearance consists of inserting a positively polarized electrode into tissue, administering H2 either by respiration or intra-arterially, allowing the H2 to be cleared from arterial blood, and then monitoring the exponential clearance rate of H2 from the tissue [39] . This technique has been validated for measuring blood flow in different organs; however, it is not used routinely for evaluation of intestinal ischemia due to its invasiveness, inconvenience and insufficient accurateness [21,29] .…”

Functional Capillary Density for in Vivo Estimation of Intestinal Perfusion using Real-Time Confocal Endomicroscopy

“…Authors could calculate a ratio of circulating blood cells to the functional bowel vascular bed as a predictive index of intestinal survival [17]. This type of accurate quantification of intestinal perfusion, when it is not time-consuming or overwhelmingly expensive, might represent a paradigmatic shift towards micro-image-guided therapies, allowing for a Doppler-like real-time examination at a microscopic scale.…”

Evaluation of the optical interference in a combined measurement system used for assessment of tissue blood flow

“…Monitoring blood flow in abdominal surgery especially intra and post-operatively would be a valuable tool for prevention of intestinal ischemia and necrosis, often requiring surgical re-exploration, resulting in significant postoperative morbidity and increased length of hospital stay. Although various monitoring techniques have been proposed to assess intestinal viability, none of these techniques have been proven reliable enough to replace visual observation [4]. The aim of the main study is to combine the established techniques, LDF and PPG, into one flexible probe intended for assessment of perfusion in abdominal tissue during bowel operation.…”