Hyperspectral imaging for perioperative monitoring of microcirculatory tissue oxygenation and tissue water content in pancreatic surgery — an observational clinical pilot study

Abstract Background Hyperspectral imaging (HSI) could provide extended haemodynamic monitoring of perioperative tissue oxygenation and tissue water content to visualize effects of haemodynamic therapy and surgical trauma. The objective of this study was to assess the capacity of HSI to monitor skin...

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Autores principales:	Maximilian Dietrich, Sebastian Marx, Maik von der Forst, Thomas Bruckner, Felix C. F. Schmitt, Mascha O. Fiedler, Felix Nickel, Alexander Studier-Fischer, Beat P. Müller-Stich, Thilo Hackert, Thorsten Brenner, Markus A. Weigand, Florian Uhle, Karsten Schmidt
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Microcirculation Haemodynamic Monitoring Hyperspectral Imaging Fluid Management Tissue Water Content Pancreatic Surgery Surgery RD1-811
Acceso en línea:	https://doaj.org/article/dcd588cc50e549edb4ed1eb40f82d4de
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spelling	oai:doaj.org-article:dcd588cc50e549edb4ed1eb40f82d4de2021-12-05T12:24:29ZHyperspectral imaging for perioperative monitoring of microcirculatory tissue oxygenation and tissue water content in pancreatic surgery — an observational clinical pilot study10.1186/s13741-021-00211-62047-0525https://doaj.org/article/dcd588cc50e549edb4ed1eb40f82d4de2021-12-01T00:00:00Zhttps://doi.org/10.1186/s13741-021-00211-6https://doaj.org/toc/2047-0525Abstract Background Hyperspectral imaging (HSI) could provide extended haemodynamic monitoring of perioperative tissue oxygenation and tissue water content to visualize effects of haemodynamic therapy and surgical trauma. The objective of this study was to assess the capacity of HSI to monitor skin microcirculation and possible relations to perioperative organ dysfunction in patients undergoing pancreatic surgery. Methods The hyperspectral imaging TIVITA® Tissue System was used to evaluate superficial tissue oxygenation (StO2), deeper layer tissue oxygenation (near-infrared perfusion index (NPI)), haemoglobin distribution (tissue haemoglobin index (THI)) and tissue water content (tissue water index (TWI)) in 25 patients undergoing pancreatic surgery. HSI parameters were measured before induction of anaesthesia (t1), after induction of anaesthesia (t2), postoperatively before anaesthesia emergence (t3), 6 h after emergence of anaesthesia (t4) and three times daily (08:00, 14:00, 20:00 ± 1 h) at the palm and the fingertips until the second postoperative day (t5–t10). Primary outcome was the correlation of HSI with perioperative organ dysfunction assessed with the perioperative change of SOFA score. Results Two hundred and fifty HSI measurements were performed in 25 patients. Anaesthetic induction led to a significant increase of tissue oxygenation parameters StO2 and NPI (t1–t2). StO2 and NPI decreased significantly from t2 until the end of surgery (t3). THI of the palm showed a strong correlation with haemoglobin levels preoperatively (t2: r = 0.83, p < 0.001) and 6 h postoperatively (t4: r = 0.71, p = 0.001) but not before anaesthesia emergence (t3: r = 0.35, p = 0.10). TWI of the palm and the fingertip rose significantly between pre- and postoperative measurements (t2–t3). Higher blood loss, syndecan level and duration of surgery were associated with a higher increase of TWI. The perioperative change of HSI parameters (∆t1–t3) did not correlate with the perioperative change of the SOFA score. Conclusion This is the first study using HSI skin measurements to visualize tissue oxygenation and tissue water content in patients undergoing pancreatic surgery. HSI was able to measure short-term changes of tissue oxygenation during anaesthetic induction and pre- to postoperatively. TWI indicated a perioperative increase of tissue water content. Perioperative use of HSI could be a useful extension of haemodynamic monitoring to assess the microcirculatory response during haemodynamic therapy and major surgery. Trial registration German Clinical Trial Register, DRKS00017313 on 5 June 2019Maximilian DietrichSebastian MarxMaik von der ForstThomas BrucknerFelix C. F. SchmittMascha O. FiedlerFelix NickelAlexander Studier-FischerBeat P. Müller-StichThilo HackertThorsten BrennerMarkus A. WeigandFlorian UhleKarsten SchmidtBMCarticleMicrocirculationHaemodynamic MonitoringHyperspectral ImagingFluid ManagementTissue Water ContentPancreatic SurgerySurgeryRD1-811ENPerioperative Medicine, Vol 10, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Microcirculation Haemodynamic Monitoring Hyperspectral Imaging Fluid Management Tissue Water Content Pancreatic Surgery Surgery RD1-811
spellingShingle	Microcirculation Haemodynamic Monitoring Hyperspectral Imaging Fluid Management Tissue Water Content Pancreatic Surgery Surgery RD1-811 Maximilian Dietrich Sebastian Marx Maik von der Forst Thomas Bruckner Felix C. F. Schmitt Mascha O. Fiedler Felix Nickel Alexander Studier-Fischer Beat P. Müller-Stich Thilo Hackert Thorsten Brenner Markus A. Weigand Florian Uhle Karsten Schmidt Hyperspectral imaging for perioperative monitoring of microcirculatory tissue oxygenation and tissue water content in pancreatic surgery — an observational clinical pilot study
description	Abstract Background Hyperspectral imaging (HSI) could provide extended haemodynamic monitoring of perioperative tissue oxygenation and tissue water content to visualize effects of haemodynamic therapy and surgical trauma. The objective of this study was to assess the capacity of HSI to monitor skin microcirculation and possible relations to perioperative organ dysfunction in patients undergoing pancreatic surgery. Methods The hyperspectral imaging TIVITA® Tissue System was used to evaluate superficial tissue oxygenation (StO2), deeper layer tissue oxygenation (near-infrared perfusion index (NPI)), haemoglobin distribution (tissue haemoglobin index (THI)) and tissue water content (tissue water index (TWI)) in 25 patients undergoing pancreatic surgery. HSI parameters were measured before induction of anaesthesia (t1), after induction of anaesthesia (t2), postoperatively before anaesthesia emergence (t3), 6 h after emergence of anaesthesia (t4) and three times daily (08:00, 14:00, 20:00 ± 1 h) at the palm and the fingertips until the second postoperative day (t5–t10). Primary outcome was the correlation of HSI with perioperative organ dysfunction assessed with the perioperative change of SOFA score. Results Two hundred and fifty HSI measurements were performed in 25 patients. Anaesthetic induction led to a significant increase of tissue oxygenation parameters StO2 and NPI (t1–t2). StO2 and NPI decreased significantly from t2 until the end of surgery (t3). THI of the palm showed a strong correlation with haemoglobin levels preoperatively (t2: r = 0.83, p < 0.001) and 6 h postoperatively (t4: r = 0.71, p = 0.001) but not before anaesthesia emergence (t3: r = 0.35, p = 0.10). TWI of the palm and the fingertip rose significantly between pre- and postoperative measurements (t2–t3). Higher blood loss, syndecan level and duration of surgery were associated with a higher increase of TWI. The perioperative change of HSI parameters (∆t1–t3) did not correlate with the perioperative change of the SOFA score. Conclusion This is the first study using HSI skin measurements to visualize tissue oxygenation and tissue water content in patients undergoing pancreatic surgery. HSI was able to measure short-term changes of tissue oxygenation during anaesthetic induction and pre- to postoperatively. TWI indicated a perioperative increase of tissue water content. Perioperative use of HSI could be a useful extension of haemodynamic monitoring to assess the microcirculatory response during haemodynamic therapy and major surgery. Trial registration German Clinical Trial Register, DRKS00017313 on 5 June 2019
format	article
author	Maximilian Dietrich Sebastian Marx Maik von der Forst Thomas Bruckner Felix C. F. Schmitt Mascha O. Fiedler Felix Nickel Alexander Studier-Fischer Beat P. Müller-Stich Thilo Hackert Thorsten Brenner Markus A. Weigand Florian Uhle Karsten Schmidt
author_facet	Maximilian Dietrich Sebastian Marx Maik von der Forst Thomas Bruckner Felix C. F. Schmitt Mascha O. Fiedler Felix Nickel Alexander Studier-Fischer Beat P. Müller-Stich Thilo Hackert Thorsten Brenner Markus A. Weigand Florian Uhle Karsten Schmidt
author_sort	Maximilian Dietrich
title	Hyperspectral imaging for perioperative monitoring of microcirculatory tissue oxygenation and tissue water content in pancreatic surgery — an observational clinical pilot study
title_short	Hyperspectral imaging for perioperative monitoring of microcirculatory tissue oxygenation and tissue water content in pancreatic surgery — an observational clinical pilot study
title_full	Hyperspectral imaging for perioperative monitoring of microcirculatory tissue oxygenation and tissue water content in pancreatic surgery — an observational clinical pilot study
title_fullStr	Hyperspectral imaging for perioperative monitoring of microcirculatory tissue oxygenation and tissue water content in pancreatic surgery — an observational clinical pilot study
title_full_unstemmed	Hyperspectral imaging for perioperative monitoring of microcirculatory tissue oxygenation and tissue water content in pancreatic surgery — an observational clinical pilot study
title_sort	hyperspectral imaging for perioperative monitoring of microcirculatory tissue oxygenation and tissue water content in pancreatic surgery — an observational clinical pilot study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/dcd588cc50e549edb4ed1eb40f82d4de
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Hyperspectral imaging for perioperative monitoring of microcirculatory tissue oxygenation and tissue water content in pancreatic surgery — an observational clinical pilot study

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