Abstract
Objective
A reliable, continuous method of monitoring splanchnic organ oxygen saturation could allow for the early detection of malperfusion, and may prevent the onset of multiple organ failure. Current monitoring techniques have not been widely accepted in critical care monitoring. As a preliminary to developing a continuous indwelling device, this study evaluates a new handheld fiber optic photoplethysmographic (PPG) sensor for estimating the blood oxygen saturation (SpO2) of splanchnic organs during surgery.
Methods
A fiber optic splanchnic PPG sensor, instrumentation system and virtual instrument were developed to facilitate PPG and SpO2 measurement from splanchnic organs. Following Local Research Ethics Committee approval, the sensor was evaluated on seventeen ASA 1 and 2 patients undergoing open laparotomy. PPG signals were obtained from the large bowel, small bowel, liver and stomach. Simultaneous PPG signals from the finger were also obtained using an identical fiber optic sensor.
Results
Good quality PPG signals with high signal-to-noise (SNR) ratios were obtained from all splanchnic sites under investigation. Analysis of the ac and dc amplitudes of the red and infrared PPG signals showed there to be a statistically significant difference between PPG signals obtained from splanchnic organs with those obtained from the finger (using fiber optic sensors). Estimated SpO2 values from the splanchnic organs show good agreement with those obtained from the finger using both a fiber optic sensor and a commercial device. Furthermore, the results of a Bland and Altman analysis indicate that fiber optic splanchnic pulse oximetry, particularly of the bowel, may provide a suitable method for monitoring splanchnic organ perfusion.
Conclusion
The evaluation of a new fiber optic sensor on anaesthetized patients undergoing laparotomy demonstrated that good quality PPG signals and SpO2 estimates can be obtained from splanchnic organs. Such a sensor may provide a useful tool for the intraoperative assessment of splanchnic perfusion.
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References
Jury of the Consensus. Tissue Hypoxia: how to detect, how to correct, how to prevent? Intensive Care Med. 1996;22:1250–1257.
Rittoo D, Gosling P, Bonnici C, Burnley S, Millns P, Simms MH, Smith SRG, Vohra RK. Splanchnic oxygenation in patients undergoing abdominal aortic aneurysm repair and volume expansion with eloHAES. Cardiovasc Surg. 2002;10:128–133.
Koch T, Geiger S, Ragaller MJR. Monitoring of organ dysfunction in sepsis/systemic inflammatory response syndrome: novel strategies. J Am Soc Nephrol. 2001;12:S53–S59.
Dantzker DR. The gastrointestinal tract -the canary of the body? JAMA. 1993;270(10):1247–1248.
Crerar-Gilbert AJ, Kyriacou PA, Jones DP, Langford RM. Assessment of photoplethysmographic signals for the determination of splanchnic oxygen saturation in humans. Anaesthesia. 2002;57:442–445.
Lauenstein TC, Hibbelnl D, Bosk S, Debatin JF, Ruehm SG. A non-invasive approach using perfusion MRI of the small bowel to diagnose mesenteric ischemia. Proc Intl Soc Mag Reson Med 2002; 10: 521.
Campbell ME, Van Aerde JE, Cheung PY, Mayes DC. Tonometry to estimate intestinal perfusion in newborn pigs, Archives of Disease in Children. Fetal Neonatal Ed. 1999;81:F105–F109.
Kinnala PJ, Kuttila KT, Gronroos JM, Havia TV, Nevalainen TJ, Niinikoski JHA. Splanchnic and pancreatic tissue perfusion in experimental acute pancreatitis. Scand J Gastroenterol. 2002;7:845–849.
Haterhill M, Tibby SM, Evan R, Murdoch IA. Gastric tonometry in septic shock. Arch Dis Child. 1998;78:155–158.
DeNobile J, Guzzetta P, Patterson K. Pulse Oximetry as a means of assessing bowel viability. J Surg Res. 1990;48:21–23.
Hickey M, Kyriacou PA. Development of a new splanchnic perfusion sensor. Conf Proc IEEE Eng Med Bil Soc. 2007;2007:2952–2955.
Webster JG. Design of pulse oximeters. Bristol: Institute of Physics Publishing; 2003.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–310.
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Hickey M, Samuels N, Randive N, Langford RM, Kyriacou PA. Investigation of photoplethysmographic signals and blood oxygen saturation values obtained from human splanchnic organs using a fiber optic sensor.
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Hickey, M., Samuels, N., Randive, N. et al. Investigation of photoplethysmographic signals and blood oxygen saturation values obtained from human splanchnic organs using a fiber optic sensor. J Clin Monit Comput 25, 245–255 (2011). https://doi.org/10.1007/s10877-011-9302-4
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DOI: https://doi.org/10.1007/s10877-011-9302-4