Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia.

<h4>Background</h4>Mesenteric ischemia is a severe and potentially lethal event. Assessment of intestine perfusion is eminently depending on the skills, and the experience of the surgeon. Thus, the therapy is biased by the right evaluation. Aim of this study is to determine the applicabi...

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Autores principales:	Anna Duprée, Henrik Rieß, Philipp H von Kroge, Jakob R Izbicki, Eike S Debus, Oliver Mann, Hans O Pinnschmidt, Detlef Russ, Christian Detter, Sabine H Wipper
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/52e23d5cbee74538a6e948c0bb105c0c
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spelling	oai:doaj.org-article:52e23d5cbee74538a6e948c0bb105c0c2021-12-02T20:06:47ZIntraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia.1932-620310.1371/journal.pone.0254144https://doaj.org/article/52e23d5cbee74538a6e948c0bb105c0c2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254144https://doaj.org/toc/1932-6203<h4>Background</h4>Mesenteric ischemia is a severe and potentially lethal event. Assessment of intestine perfusion is eminently depending on the skills, and the experience of the surgeon. Thus, the therapy is biased by the right evaluation. Aim of this study is to determine the applicability, and the usefulness of fluorescent-imaging (FI) with indocyanine green (ICG) in a porcine model of mesenteric ischemia. Second end-point is the verification of a visual and quantitative assessment tool of the intestinal perfusion.<h4>Methods</h4>In 18 pigs (54,2 ±2,9kg) an occlusion of a side-branch of the mesenteric artery was performed for 3 (group I, n = 7), 6 (group II, n = 7), and 10 hours (group III, n = 4). After reperfusion a 60 minutes observation period was carried out. 3 regions of interest were defined: ischemic bowel (D1), transitional zone (D2), and non-ischemic bowel (D3). ICG-FI was performed during baseline (T0), occlusion (T1), reperfusion (T2) and after an observation period of 60 minutes (T4).<h4>Results</h4>All experiments could be finished successfully. ICG-FI was assessed using assessment of background-subtracted peak fluorescence intensity (BSFI), slope of fluorescence intensity (SFI), and a baseline adjusted ratio of both parameters. ICG-FI confirmed loss of perfusion in D1, decreased perfusion in D2, and increased perfusion in D3. After reperfusion ICG-FI increased in group 2 due to a severe tissue damage resulting in a capillary leakage. In group I ICG-FI was equal to baseline values indicating the totally reversible loss of perfusion.<h4>Conclusion</h4>Using ICG-FI to estimate intestine perfusion after different durations of ischemia is viable using a porcine model of mesenteric ischemia. Even small differences in perfusion can be reliably determined by ICG-FI. Thus, ICG-FI is an encouraging method to evaluate intestine perfusion intraoperatively.Anna DupréeHenrik RießPhilipp H von KrogeJakob R IzbickiEike S DebusOliver MannHans O PinnschmidtDetlef RussChristian DetterSabine H WipperPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254144 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Anna Duprée Henrik Rieß Philipp H von Kroge Jakob R Izbicki Eike S Debus Oliver Mann Hans O Pinnschmidt Detlef Russ Christian Detter Sabine H Wipper Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia.
description	<h4>Background</h4>Mesenteric ischemia is a severe and potentially lethal event. Assessment of intestine perfusion is eminently depending on the skills, and the experience of the surgeon. Thus, the therapy is biased by the right evaluation. Aim of this study is to determine the applicability, and the usefulness of fluorescent-imaging (FI) with indocyanine green (ICG) in a porcine model of mesenteric ischemia. Second end-point is the verification of a visual and quantitative assessment tool of the intestinal perfusion.<h4>Methods</h4>In 18 pigs (54,2 ±2,9kg) an occlusion of a side-branch of the mesenteric artery was performed for 3 (group I, n = 7), 6 (group II, n = 7), and 10 hours (group III, n = 4). After reperfusion a 60 minutes observation period was carried out. 3 regions of interest were defined: ischemic bowel (D1), transitional zone (D2), and non-ischemic bowel (D3). ICG-FI was performed during baseline (T0), occlusion (T1), reperfusion (T2) and after an observation period of 60 minutes (T4).<h4>Results</h4>All experiments could be finished successfully. ICG-FI was assessed using assessment of background-subtracted peak fluorescence intensity (BSFI), slope of fluorescence intensity (SFI), and a baseline adjusted ratio of both parameters. ICG-FI confirmed loss of perfusion in D1, decreased perfusion in D2, and increased perfusion in D3. After reperfusion ICG-FI increased in group 2 due to a severe tissue damage resulting in a capillary leakage. In group I ICG-FI was equal to baseline values indicating the totally reversible loss of perfusion.<h4>Conclusion</h4>Using ICG-FI to estimate intestine perfusion after different durations of ischemia is viable using a porcine model of mesenteric ischemia. Even small differences in perfusion can be reliably determined by ICG-FI. Thus, ICG-FI is an encouraging method to evaluate intestine perfusion intraoperatively.
format	article
author	Anna Duprée Henrik Rieß Philipp H von Kroge Jakob R Izbicki Eike S Debus Oliver Mann Hans O Pinnschmidt Detlef Russ Christian Detter Sabine H Wipper
author_facet	Anna Duprée Henrik Rieß Philipp H von Kroge Jakob R Izbicki Eike S Debus Oliver Mann Hans O Pinnschmidt Detlef Russ Christian Detter Sabine H Wipper
author_sort	Anna Duprée
title	Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia.
title_short	Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia.
title_full	Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia.
title_fullStr	Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia.
title_full_unstemmed	Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia.
title_sort	intraoperative quality assessment of tissue perfusion with indocyanine green (icg) in a porcine model of mesenteric ischemia.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/52e23d5cbee74538a6e948c0bb105c0c
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Intraoperative quality assessment of tissue perfusion with indocyanine green (ICG) in a porcine model of mesenteric ischemia.

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