The use of infrared photoplethysmography in identifying early intestinal ischemia
W. H. Pearce, D. N. Jones, G. H. Warren, E. J. Bartle, T. A. Whitehill and R. B. Rutherford
Acute intestinal ischemia and infarction remain serious clinical problems
despite early operative intervention. An accurate and reproducible method
of assessing ischemic tissue is critical to determine the precise limits of
resection. The purpose of this study was to compare the utility of infrared
photoplethysmography, intravenous fluorescein, and Doppler ultrasound in
assessing intestinal ischemia in an operative canine model. After five
segmental mesenteric arterial ligations in each of six conditioned dogs,
the detection threshold for the limits of arterial perfusion of each
modality was determined and correlated with the respective histopathologic
specimens. Infrared photoplethysmography proved to be 100% sensitive for
ischemia when its waveform amplitudes were 50% or greater of matched
reference waveforms, whereas both intravenous fluorescein and Doppler
ultrasound were 88% sensitive. All were comparably specific. We conclude
that infrared photoplethysmography is comparable to intravenous fluorescein
and Doppler ultrasound in the assessment of ischemic intestinal segments.
