Orthogonal polarization spectroscopy to detect mesenteric hypoperfusion

Bracht, Hendrik; Krejci, Vladimir; Hiltebrand, Luzius; Brandt, Sebastian; Sigurdsson, Gisli; Ali, Syed Z; Takala, Jukka; Jakob, Stephan M (2008). Orthogonal polarization spectroscopy to detect mesenteric hypoperfusion. Intensive care medicine, 34(10), pp. 1883-90. Berlin: Springer-Verlag 10.1007/s00134-008-1130-8

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OBJECTIVE: Orthogonal polarization spectral (OPS) imaging is used to assess mucosal microcirculation. We tested sensitivity and variability of OPS in the assessment of mesenteric blood flow (Q (sma)) reduction. SETTING: University Animal Laboratory. INTERVENTIONS: In eight pigs, Q (sma) was reduced in steps of 15% from baseline; five animals served as controls. Jejunal mucosal microcirculatory blood flow was recorded with OPS and laser Doppler flowmetry at each step. OPS data from each period were collected and randomly ordered. Samples from each period were individually chosen by two blinded investigators and quantified [capillary density (number of vessels crossing predefined lines), number of perfused villi] after agreement on the methodology. MEASUREMENT AND RESULTS: Interobserver coefficient of variation (CV) for capillary density from samples representing the same flow condition was 0.34 (0.04-1.41) and intraobserver CV was 0.10 (0.02-0.61). Only one investigator observed a decrease in capillary density [to 62% (48-82%) of baseline values at 45% Q (sma) reduction; P = 0.011], but comparisons with controls never revealed significant differences. In contrast, reduction in perfused villi was detected by both investigators at 75% of mesenteric blood flow reduction. Laser Doppler flow revealed heterogeneous microcirculatory perfusion. CONCLUSIONS: Assessment of capillary density did not reveal differences between animals with and without Q (sma) reduction, and evaluation of perfused villi revealed blood flow reduction only when Q (sma) was very low. Potential explanations are blood flow redistribution and heterogeneity, and suboptimal contrast of OPS images. Despite agreement on the method of analysis, interobserver differences in the quantification of vessel density on gut mucosa using OPS are high.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Bracht, Hendrik; Krejci, Vladimir; Hiltebrand, Luzius; Brandt, Sebastian; Ali, Syed Z.; Takala, Jukka and Jakob, Stephan

ISSN:

0342-4642

ISBN:

18516589

Publisher:

Springer-Verlag

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

04 Oct 2013 15:01

Last Modified:

26 Jun 2018 13:25

Publisher DOI:

10.1007/s00134-008-1130-8

PubMed ID:

18516589

Web of Science ID:

000259570100023

BORIS DOI:

10.7892/boris.26657

URI:

https://boris.unibe.ch/id/eprint/26657 (FactScience: 81068)

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