Predicting intestinal viability by consecutive photoacoustic monitoring of oxygenation recovery after reperfusion in acute mesenteric ischemia in rats

Takumi Sugiura,Takahiro Ogi,Kenichiro Okumura,Takahiro Komori,Toshifumi Gabata,Junichi Matsumoto,Dai Inoue,Satoshi Kobayashi,Maki Sakaguchi,Wataru Koda

doi:10.1038/s41598-021-98904-x

Takumi Sugiura, Takahiro Ogi + Show 8 more

Open Access

https://doi.org/10.1038/s41598-021-98904-x

Copy DOI

Abstract

The purpose was to assess whether consecutive monitoring of oxygenation by photoacoustic imaging (PAI) can objectively predict intestinal viability during surgery for acute mesenteric ischemia (AMI). PAI uses laser light to detect relative amounts of oxygenated and deoxygenated hemoglobin in intestinal tissue. In 30 rats, AMI was induced by clamping the mesenteric and marginal vessels of the ileum for 0 min in the control group, 30 min in the mild group, and 180 min in the severe group (10 rats per group). After 60 min of reperfusion, intestinal damage was evaluated pathologically. Oxygenation of the intestine was monitored throughout the procedure in real time by a commercially available PAI system and compared among the groups. All rats showed irreversible (i.e. transmucosal or transmural infarction) damage in the severe group. After reperfusion, the oxygenation in the mild group recovered immediately and was significantly higher than in the severe group at 1, 5, 10, 30, and 60 min (P = .011, 002, < .001, 001, and 001, respectively). Oxygenation showed a significant strong negative correlation with pathological severity (rs = − 0.7783, − 0.7806, − 0.7422, − 0.7728, and − 0.7704, respectively). In conclusion, PAI could objectively predict irreversible ischemic damage immediately after reperfusion, which potentially prevents inadequate surgery.

Highlights

The purpose was to assess whether consecutive monitoring of oxygenation by photoacoustic imaging (PAI) can objectively predict intestinal viability during surgery for acute mesenteric ischemia (AMI)
PAI uses a wide range of the spectrum including the near-infrared spectrum, which has deep penetration and visualizes deep tissue in vivo in real time
The usefulness of PAI as an objective and quantitative evaluation method after ischemia and reperfusion has been widely reported in various organs including intestine[20,22,23], and the feasibility of evaluating oxygenation by PAI has been e stablished[24]

Summary

Introduction

The purpose was to assess whether consecutive monitoring of oxygenation by photoacoustic imaging (PAI) can objectively predict intestinal viability during surgery for acute mesenteric ischemia (AMI). During surgery for acute mesenteric ischemia (AMI), since there is no reliable objective marker of intestinal viability to determine the resection margin, it is assessed subjectively by the surgeon. This requires a high level of clinical e xperience[1,2,3,4]. The usefulness of oxygenation mapping in organ ischemia has been reported[16,17,18]

Objectives

Discussion

Conclusion