Assessment of Gut Mucosal Perfusion and Colonic Tissue Blood Flow During Abdominal Aortic Surgery with Gastric Tonometry and Laser Doppler Flowmetry

The objective of this study was to investigate the effect of infrarenal aortic cross-clamping and unclamping on gut mucosal perfusion by gastric tonometry and on sigmoid colonic tissue blood flow by laser Doppler flowmetry during abdominal aortic surgery. This was a prospective before-and-after inte...

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Bibliographic Details
Published in:Vascular and endovascular surgery 2002-05, Vol.36 (3), p.193-198
Main Author: Nakatsuka, Mitsuru
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - surgery
Biological and medical sciences
Blood Pressure
Cardiac Output
Colon, Sigmoid - blood supply
Constriction
Female
Gastric Mucosa - blood supply
Humans
Hydrogen-Ion Concentration
Intestinal Mucosa - blood supply
Intraoperative Period
Laser-Doppler Flowmetry
Male
Medical sciences
Middle Aged
Prospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
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Summary:The objective of this study was to investigate the effect of infrarenal aortic cross-clamping and unclamping on gut mucosal perfusion by gastric tonometry and on sigmoid colonic tissue blood flow by laser Doppler flowmetry during abdominal aortic surgery. This was a prospective before-and-after intervention comparison study in a university hospital of 8 male patients, aged 57-87, undergoing elective infrarenal abdominal aortic surgery. Each patient was pretreated with ranitidine. Following general anesthesia, a nasogastric tonometer was inserted into the stomach. The balloon of the tonometer was filled with 2.5 mL of normal saline for gas tension and pH analysis. This process was repeated before and after aortic cross-clamping and unclamping. Gastric mucosal pHi was calculated with the Henderson-Hasselbalch equation from the arterial Hco3 and the tonometrically measured mucosal Pco2. A laser Doppler flow probe was placed in contact with the serosa of the sigmoid colon against the mesentery after the abdomen was opened. Sigmoid colonic tissue blood flow (SCBF) was assessed by the laser Doppler flowmeter. Gastric mucosal pHi by gastric tonometry and colonic tissue blood flow by laser Doppler flowmetry were measured before and after aortic cross-clamping and unclamping. Gastric mucosal pHi decreased significantly 30 minutes after aortic cross-clamping (7.37 +0.07) (p
ISSN:1538-5744
1938-9116
DOI:10.1177/153857440203600306