T Sommer1, J F Larsen. 1. Department of Surgical Gastroenterology, Aalborg University Hospital, Aalborg, Denmark. sommers@privat.dk
Abstract
BACKGROUND: The aim was to investigate the possibility of using intraluminal or intraperitoneal microdialysis to monitor regional intestinal ischaemia. METHODS: Microdialysis catheters were inserted in the lumen, in and outside the intestinal wall, and in the peritoneum of each of ten pigs. Regional occlusive ischaemia was induced in 100 cm of jejunum. Levels of glucose, pyruvate, lactate and glycerol in the microdialysate were measured at 20-min intervals before and after induction of ischaemia. Systemic haemodynamics were monitored and laser Doppler flowmetry (LDF) recordings made in each of the intestinal segments. RESULTS: Ischaemia caused a significant decrease in glucose level, and an increase in lactate and glycerol concentrations and lactate/pyruvate ratio, at all catheters, although glucose could not be detected by the intraluminal catheter. The metabolic changes occurred simultaneously and were statistically significant in almost all catheters after 100 min. LDF revealed a significant decrease in intestinal blood flow, but there was considerable individual variation. CONCLUSION: Regional occlusive ischaemia in 100 cm of small intestine could be detected and monitored by means of a microdialysis catheter placed in the peritoneal cavity or the bowel lumen. Copyright 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
BACKGROUND: The aim was to investigate the possibility of using intraluminal or intraperitoneal microdialysis to monitor regional intestinal ischaemia. METHODS: Microdialysis catheters were inserted in the lumen, in and outside the intestinal wall, and in the peritoneum of each of ten pigs. Regional occlusive ischaemia was induced in 100 cm of jejunum. Levels of glucose, pyruvate, lactate and glycerol in the microdialysate were measured at 20-min intervals before and after induction of ischaemia. Systemic haemodynamics were monitored and laser Doppler flowmetry (LDF) recordings made in each of the intestinal segments. RESULTS:Ischaemia caused a significant decrease in glucose level, and an increase in lactate and glycerol concentrations and lactate/pyruvate ratio, at all catheters, although glucose could not be detected by the intraluminal catheter. The metabolic changes occurred simultaneously and were statistically significant in almost all catheters after 100 min. LDF revealed a significant decrease in intestinal blood flow, but there was considerable individual variation. CONCLUSION: Regional occlusive ischaemia in 100 cm of small intestine could be detected and monitored by means of a microdialysis catheter placed in the peritoneal cavity or the bowel lumen. Copyright 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Authors: Colin L Verdant; Marialuisa Chierego; Véronique De Moor; Reza Chamlou; Jacques Creteur; Jean de Dieu Mutijima; Patricia Loi; Michel Gelin; Antonino Gullo; Jean-Louis Vincent; Daniel De Backer Journal: Ann Surg Date: 2006-12 Impact factor: 12.969