The Use of Infrared Photoplethysmography in Identifying Early Intestinal Ischemia

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Abstract
• Acute intestinal ischemia and infarction remain serious clinical problems despite early operative intervention. An accurate and reproducible method of assessing ischemictissue 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. (Arch Surg 1987;122:308-310)

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