Center for Surgical Science, Zealand University Hospital, Lykkebækvej 1, 4600, Køge, Denmark.
Department of Surgery, Copenhagen University Hospital, Herlev & Gentofte, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.
Surg Endosc. 2024 Aug;38(8):4296-4305. doi: 10.1007/s00464-024-10938-0. Epub 2024 Jun 13.
Preserving sufficient oxygen supply to the tissue is fundamental for maintaining organ function. However, our ability to identify those at risk and promptly recognize tissue hypoperfusion during abdominal surgery is limited. To address this problem, we aimed to develop a new method of perfusion monitoring that can be used during surgical procedures and aid surgeons' decision-making.
In this experimental porcine study, thirteen subjects were randomly assigned one organ of interest [stomach (n = 3), ascending colon (n = 3), rectum (n = 3), and spleen (n = 3)]. After baseline perfusion recordings, using high-frequency, low-dose bolus injections with weight-adjusted (0.008 mg/kg) ICG, organ-supplying arteries were manually and completely occluded leading to hypoperfusion of the target organ. Continuous organ perfusion monitoring was performed throughout the experimental conditions.
After manual occlusion of pre-selected organ-supplying arteries, occlusion of the peripheral arterial supply translated in an immediate decrease in oscillation signal in most organs (3/3 ventricle, 3/3 ascending colon, 3/3 rectum, 2/3 spleen). Occlusion of the central arterial supply resulted in a further decrease or complete disappearance of the oscillation curves in the ventricle (3/3), ascending colon (3/3), rectum (3/3), and spleen (1/3).
Continuous organ-perfusion monitoring using a high-frequency, low-dose ICG bolus regimen can detect organ hypoperfusion in real-time.
为维持器官功能，确保组织有充足的氧气供应是至关重要的。然而，我们识别高危人群和及时发现腹部手术中组织灌注不足的能力有限。为了解决这个问题，我们旨在开发一种新的灌注监测方法，可用于手术过程并辅助外科医生做出决策。
在这项实验性猪研究中，13 名受试者被随机分配到一个感兴趣的器官[胃（n=3）、升结肠（n=3）、直肠（n=3）和脾（n=3）]。在基线灌注记录后，使用高频、低剂量的体重调整（0.008mg/kg）ICG 进行弹丸式注射，手动完全阻断供应器官的动脉，导致目标器官的灌注不足。在整个实验条件下持续进行器官灌注监测。
在预选的供应器官动脉手动闭塞后，外周动脉供应的闭塞立即导致大多数器官的振荡信号立即下降（3/3 心室、3/3 升结肠、3/3 直肠、2/3 脾）。中央动脉供应的闭塞导致心室（3/3）、升结肠（3/3）、直肠（3/3）和脾（1/3）的振荡曲线进一步下降或完全消失。
使用高频、低剂量 ICG 弹丸方案的连续器官灌注监测可实时检测器官灌注不足。
