Validation of quantitative assessment of indocyanine green fluorescent imaging in a one-vessel model

Objectives Evaluation of intestinal perfusion remains subjective and depends on the surgeon´s individual experience. Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) fluorescence using a near-infrared camera system has been described in different ways and for differ...

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Main Authors: Anna Duprée, Henrik C. Rieß, Philipp H. von Kroge, Jakob R. Izbicki, Eike S. Debus, Oliver Mann, Hans O. Pinnschmidt, Detlef Russ, Christian Detter, Sabine H. Wipper, Diego Raimondo
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673564/?tool=EBI
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author Anna Duprée
Henrik C. Rieß
Philipp H. von Kroge
Jakob R. Izbicki
Eike S. Debus
Oliver Mann
Hans O. Pinnschmidt
Detlef Russ
Christian Detter
Sabine H. Wipper
Diego Raimondo
author_facet Anna Duprée
Henrik C. Rieß
Philipp H. von Kroge
Jakob R. Izbicki
Eike S. Debus
Oliver Mann
Hans O. Pinnschmidt
Detlef Russ
Christian Detter
Sabine H. Wipper
Diego Raimondo
author_sort Anna Duprée
collection DOAJ
description Objectives Evaluation of intestinal perfusion remains subjective and depends on the surgeon´s individual experience. Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) fluorescence using a near-infrared camera system has been described in different ways and for different indications. The aim of the present study was to evaluate fluorescent imaging (FI) in the quantitative assessment of intestinal perfusion in a gastric tube model in pigs and to compare the results to results obtained with florescent microspheres (FM), the gold standard for tissue perfusion. Methods Seven pigs (56.0±3.0 kg), both males and females, underwent gastric tube formation after transection and ligation of the gastric arteries, except the right gastroepiploic artery, to avoid collateral blood flow. After baseline assessment (T0), hypotension (T1) was induced by propofol (Karampinis et al 2017) (< 60 mmHg). Then, propofol was paused to obtain normotension (T2, Mean arterial pressure (MAP) 60–90 mmHg). Finally, hypertension (T3, MAP>90 mmHg) was induced by norepinephrine. Measurements were performed in three regions of interest (ROIs) under standardized conditions: the fundus (D1), corpus (D2), and prepyloric area (D3). Hemodynamic parameters and transit-time flow measurement (TTFM) in the right gastroepiploic artery were continuously assessed. FI, FM and the partial pressure of tissue oxygen (TpO2) were quantified in each ROI. Results The study protocol could successfully be performed during stable hemodynamics. Flow in the gastroepiploic artery measured by transit time flow measurement (TTFM) was related to hemodynamic changes between the measurements, indicating improved blood flow with increasing MAP. The distal part of the gastric tube (D1) showed significantly (p<0.05) impaired perfusion compared to the proximal parts D3 and D2 using FM. ICG-FI also showed the highest values in D3 and the lowest values in D1 at all hemodynamic levels (T1-T3; p<0,05). Conclusion Visual and quantitative assessment of gastric tube perfusion is feasible in an experimental setting using ICG-FI. This might be a promising tool for intraoperative assessment during visceral surgery in the future.
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spelling doaj.art-c602f74863d54fb4b698d8cad70b00822022-12-22T00:54:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-011511Validation of quantitative assessment of indocyanine green fluorescent imaging in a one-vessel modelAnna DupréeHenrik C. RießPhilipp H. von KrogeJakob R. IzbickiEike S. DebusOliver MannHans O. PinnschmidtDetlef RussChristian DetterSabine H. WipperDiego RaimondoObjectives Evaluation of intestinal perfusion remains subjective and depends on the surgeon´s individual experience. Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) fluorescence using a near-infrared camera system has been described in different ways and for different indications. The aim of the present study was to evaluate fluorescent imaging (FI) in the quantitative assessment of intestinal perfusion in a gastric tube model in pigs and to compare the results to results obtained with florescent microspheres (FM), the gold standard for tissue perfusion. Methods Seven pigs (56.0±3.0 kg), both males and females, underwent gastric tube formation after transection and ligation of the gastric arteries, except the right gastroepiploic artery, to avoid collateral blood flow. After baseline assessment (T0), hypotension (T1) was induced by propofol (Karampinis et al 2017) (< 60 mmHg). Then, propofol was paused to obtain normotension (T2, Mean arterial pressure (MAP) 60–90 mmHg). Finally, hypertension (T3, MAP>90 mmHg) was induced by norepinephrine. Measurements were performed in three regions of interest (ROIs) under standardized conditions: the fundus (D1), corpus (D2), and prepyloric area (D3). Hemodynamic parameters and transit-time flow measurement (TTFM) in the right gastroepiploic artery were continuously assessed. FI, FM and the partial pressure of tissue oxygen (TpO2) were quantified in each ROI. Results The study protocol could successfully be performed during stable hemodynamics. Flow in the gastroepiploic artery measured by transit time flow measurement (TTFM) was related to hemodynamic changes between the measurements, indicating improved blood flow with increasing MAP. The distal part of the gastric tube (D1) showed significantly (p<0.05) impaired perfusion compared to the proximal parts D3 and D2 using FM. ICG-FI also showed the highest values in D3 and the lowest values in D1 at all hemodynamic levels (T1-T3; p<0,05). Conclusion Visual and quantitative assessment of gastric tube perfusion is feasible in an experimental setting using ICG-FI. This might be a promising tool for intraoperative assessment during visceral surgery in the future.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673564/?tool=EBI
spellingShingle Anna Duprée
Henrik C. Rieß
Philipp H. von Kroge
Jakob R. Izbicki
Eike S. Debus
Oliver Mann
Hans O. Pinnschmidt
Detlef Russ
Christian Detter
Sabine H. Wipper
Diego Raimondo
Validation of quantitative assessment of indocyanine green fluorescent imaging in a one-vessel model
PLoS ONE
title Validation of quantitative assessment of indocyanine green fluorescent imaging in a one-vessel model
title_full Validation of quantitative assessment of indocyanine green fluorescent imaging in a one-vessel model
title_fullStr Validation of quantitative assessment of indocyanine green fluorescent imaging in a one-vessel model
title_full_unstemmed Validation of quantitative assessment of indocyanine green fluorescent imaging in a one-vessel model
title_short Validation of quantitative assessment of indocyanine green fluorescent imaging in a one-vessel model
title_sort validation of quantitative assessment of indocyanine green fluorescent imaging in a one vessel model
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673564/?tool=EBI
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