Quantitative fluorescence angiography detects dynamic changes in gastric perfusion
- 1 December 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Surgical Endoscopy
- Vol. 35 (12), 6786-6795
- https://doi.org/10.1007/s00464-020-08183-2
Abstract
Introduction The use of Indocyanine green (ICG) fluorescence angiography (ICG-FA) is an applied method to assess visceral perfusion during surgical procedures worldwide. Further development has entailed quantification of the fluorescence signal; however, whether quantified ICG-FA can detect intraoperative changes in perfusion after hemorrhage has not been investigated previously. In this study, we investigated whether a quantification method, developed and validated in our department (q-ICG), could detect changes in gastric perfusion induced by hemorrhage and resuscitation. Methods Ten pigs were included in the study. Specific regions of interest of the stomach were chosen, and three q-ICG measurements of gastric perfusion obtained: 20 min after completion of the laparoscopic setup (baseline), after reducing the circulating blood volume by 30%, and after reinfusion of the withdrawn blood volume. Hemodynamic variables were recorded, and blood samples were collected every 10 min during the procedure. Results The reduction in blood volume generated decreased gastric perfusion (q-ICG) from baseline (p = 0.023), and gastric perfusion subsequently increased (p < 0.001) after the reintroduction of the withdrawn blood volume. Cardiac output (CO) and mean arterial blood pressure (MAP) shifted correspondingly and the gastric perfusion correlated to CO (r = 0.575, p = 0.001) and MAP (r = 0.436, p = 0.018). Conclusion We present a novel study showing that the q-ICG method can detect dynamic changes in local tissue perfusion induced by hemorrhage and resuscitation. As regional gastrointestinal perfusion may be significantly reduced, while hemodynamic variables such as MAP or heart rate remain stable, q-ICG may provide an objective, non-invasive method for detecting regional early ischemia, strengthening surgical decision making.Keywords
Funding Information
- Department of Surgical Gastroenterology Research Fund (no number)
This publication has 66 references indexed in Scilit:
- A Review of Indocyanine Green Fluorescent Imaging in SurgeryInternational Journal of Biomedical Imaging, 2012
- Physiological, Hematological, and Clinical Chemistry Parameters, Including Conversion FactorsPublished by Informa UK Limited ,2010
- The Principle of ICG Fluorescence Method~!2009-11-30~!2009-12-23~!2010-05-26~!The Open Surgical Oncology Journal, 2010
- Review of laser speckle contrast techniques for visualizing tissue perfusionLasers in Medical Science, 2008
- Changes in Gastric Intramucosal pH following Mesenteric Traction in Patients Undergoing Pancreas SurgeryDigestive Surgery, 1999
- Smoking, hypertension, and colonic anastomotic healing; a combined clinical and histopathological study.Gut, 1996
- SIMULTANEOUS INDOCYANINE GREEN AND FLUORESCEIN ANGIOGRAPHYRetina, 1995
- Heterogeneous regional vascular responses to simulated transient hypovolemia in manIntensive Care Medicine, 1994
- Acute superior mesenteric ischaemiaBritish Journal of Surgery, 1987
- The Splanchnic Circulation: Intrinsic RegulationAnnual Review of Physiology, 1981