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Surface microdialysis on small bowel serosa in monitoring of ischemia

ÅKESSON, OSCAR LU ; Abrahamsson, Pernilla; Johansson, Göran and Blind, Per Jonas (2016) In Journal of Surgical Research 204(1). p.39-46
Abstract

Background Ischemic injury of an organ causes metabolic change from aerobic to anaerobic metabolism. It has been shown in experimental studies on the heart and liver that such conversion may be detected by conventional microdialysis probes placed intra-parenchymatously, as well as on organ surfaces, by assaying lactate, pyruvate, glucose, and glycerol in dialysate. We developed a microdialysis probe (S-μD) intended for use solely on organ surfaces. The aim of this study was to assess whether the newly developed S-μD probe could be used for detection and monitoring of small bowel ischemia. Methods In anesthetized normoventilated pigs, a control S-μD probe was applied on the jejunal serosa 50 cm downstream from the duodenojejunal junction... (More)

Background Ischemic injury of an organ causes metabolic change from aerobic to anaerobic metabolism. It has been shown in experimental studies on the heart and liver that such conversion may be detected by conventional microdialysis probes placed intra-parenchymatously, as well as on organ surfaces, by assaying lactate, pyruvate, glucose, and glycerol in dialysate. We developed a microdialysis probe (S-μD) intended for use solely on organ surfaces. The aim of this study was to assess whether the newly developed S-μD probe could be used for detection and monitoring of small bowel ischemia. Methods In anesthetized normoventilated pigs, a control S-μD probe was applied on the jejunal serosa 50 cm downstream from the duodenojejunal junction (DJJ). Starting 100 cm from DJJ, a 100-cm long ischemic segment was created by division of all mesenteric vessels. S-μDs were applied at 2.5, 5, 20, and 50 cm from the starting point of ischemia by serosal sutures. A standard μD probe was placed in the abdominal cavity as a further control. Dialysate was harvested before inducing ischemia and subsequently every 20 min for 4 h. Central venous blood was drawn every hour to monitor systemic lactate, C-reactive protein, and white blood cell count. Results Microdialysis lactate levels were significantly higher than baseline from 20 min on into protocol time in the ischemic segment and in the control S-μD probe. The peritoneal cavity probe showed no significant elevation. Lactate levels from the ischemic segment reached a plateau at 60 min. Courses of pyruvate, glucose, and glycerol levels were in accordance with transition from an aerobic to anaerobic metabolism in the bowel wall. No statistically significant changes in hemoglobin, white blood cell count, or lactate values in central venous blood were recorded. Conclusions Assaying the aforementioned compounds in dialysate, harvested by the newly developed S-μD probe, allowed detection and monitoring of small bowel ischemia from 20 min on following its onset.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bowel, Experimental surgery, Ischemia, Pig, Surface microdialysis
in
Journal of Surgical Research
volume
204
issue
1
pages
8 pages
publisher
Elsevier
external identifiers
  • scopus:84969504468
  • wos:000380750000008
ISSN
0022-4804
DOI
10.1016/j.jss.2016.04.001
language
English
LU publication?
yes
id
70933dc1-9798-4254-ab0f-164b7fd1bb6f
date added to LUP
2016-06-16 09:01:54
date last changed
2017-01-01 08:28:01
@article{70933dc1-9798-4254-ab0f-164b7fd1bb6f,
  abstract     = {<p>Background Ischemic injury of an organ causes metabolic change from aerobic to anaerobic metabolism. It has been shown in experimental studies on the heart and liver that such conversion may be detected by conventional microdialysis probes placed intra-parenchymatously, as well as on organ surfaces, by assaying lactate, pyruvate, glucose, and glycerol in dialysate. We developed a microdialysis probe (S-μD) intended for use solely on organ surfaces. The aim of this study was to assess whether the newly developed S-μD probe could be used for detection and monitoring of small bowel ischemia. Methods In anesthetized normoventilated pigs, a control S-μD probe was applied on the jejunal serosa 50 cm downstream from the duodenojejunal junction (DJJ). Starting 100 cm from DJJ, a 100-cm long ischemic segment was created by division of all mesenteric vessels. S-μDs were applied at 2.5, 5, 20, and 50 cm from the starting point of ischemia by serosal sutures. A standard μD probe was placed in the abdominal cavity as a further control. Dialysate was harvested before inducing ischemia and subsequently every 20 min for 4 h. Central venous blood was drawn every hour to monitor systemic lactate, C-reactive protein, and white blood cell count. Results Microdialysis lactate levels were significantly higher than baseline from 20 min on into protocol time in the ischemic segment and in the control S-μD probe. The peritoneal cavity probe showed no significant elevation. Lactate levels from the ischemic segment reached a plateau at 60 min. Courses of pyruvate, glucose, and glycerol levels were in accordance with transition from an aerobic to anaerobic metabolism in the bowel wall. No statistically significant changes in hemoglobin, white blood cell count, or lactate values in central venous blood were recorded. Conclusions Assaying the aforementioned compounds in dialysate, harvested by the newly developed S-μD probe, allowed detection and monitoring of small bowel ischemia from 20 min on following its onset.</p>},
  author       = {ÅKESSON, OSCAR and Abrahamsson, Pernilla and Johansson, Göran and Blind, Per Jonas},
  issn         = {0022-4804},
  keyword      = {Bowel,Experimental surgery,Ischemia,Pig,Surface microdialysis},
  language     = {eng},
  month        = {07},
  number       = {1},
  pages        = {39--46},
  publisher    = {Elsevier},
  series       = {Journal of Surgical Research},
  title        = {Surface microdialysis on small bowel serosa in monitoring of ischemia},
  url          = {http://dx.doi.org/10.1016/j.jss.2016.04.001},
  volume       = {204},
  year         = {2016},
}