Laser Speckle Contrast Imaging to Evaluate Bowel Lesions in Neonates with NEC

Abstract

Background Necrotizing enterocolitis (NEC) is the most frequent surgical emergency in newborns. Intestinal ischemia is considered a factor that precedes the development of NEC lesions. Laser speckle contrast imaging (LSCI) can be used to assess tissue microcirculation. We evaluated if LSCI may help to detect intestinal regions with reduced microcirculation in NEC. Case Report A male patient (gestational age, 26 [3/7] weeks; birth weight, 600 g) showed clinical signs of NEC 28 days after birth. X-ray revealed pneumatosis intestinalis and portal gas. Laparotomy showed NEC lesions with signs of transmural ischemia in the terminal ileum and cecum. Surgical resection lines (RLs) were marked, followed by LSCI measurements and resection of the bowel between the two RLs. Post hoc LSCI analyses were conducted on both sides of the proximal and distal RL. Low-flux values, indicating reduced microcirculation, were found in the macroscopically assessed necrotic bowel at the proximal RL, whereas higher flux values, indicating sufficient microcirculation, were found in the macroscopically assessed normal bowel. Discussion This study is the first description of intra-abdominal use of LSCI to evaluate tissue microcirculation in relation to NEC lesions. LSCI could be a valuable tool to distinguish between ischemic and nonischemic bowel in neonates undergoing surgery for NEC.

Clinical applications of laser speckle contrast imaging: a review

“…Next to this, LSCI is sensitive enough to detect even the slightest changes in the gastric microvascular perfusion. Finally, Knudsun et al 94 used LSCI to measure microperfusion on the bowel of a newborn with necrotizing enterocolitis. The perfusion values matched with the macroscopic findings of the surgeon for the surgical resection lines in a post hoc analysis.…”

Predicting successful lumbar plexus block using blood flow index measured by laser speckle contrast imaging

“…LSCI has been widely applied in clinical practice to better quantify the microcirculation perfusion in real time. [30][31][32][33] Compared with the traditional assessment methods such as pinprick or cold sensory tests, LSCI measurement was objective, simple, and powerful. Traditional block assessing methods depend on patients' subjective judgement to the pinprick or cold stimuli, which is not applicable in special patient population (such as elderly patients with preoperative cognitive dysfunction, children, patients with mental problems, and patients who received peripheral nerve block after general anesthesia).…”

Predicting successful lumbar plexus block using blood flow index measured by laser speckle contrast imaging

“…LSCI has been widely applied in clinical practice to better quantify the microcirculation perfusion in real time. [33][34][35][36] Compared with the traditional assessment methods such as pinprick or cold sensory tests, LSCI measurement was objective, simple, and powerful. Traditional block assessing methods depend on patients' subjective judgement to the pinprick or cold stimuli, which is not applicable in special patient population (such as elderly patients with preoperative cognitive dysfunction, children, patients with mental problems, and patients who received peripheral nerve block after general anesthesia).…”