RESUMEN
A new, continuous method of monitoring splanchnic organ oxygen saturation (SpO(2)) would make the early detection of inadequate tissue oxygenation feasible, reducing the risk of hypoperfusion, severe ischaemia, and, ultimately, death. In an attempt to provide such a device, a new fibre optic based reflectance pulse oximeter probe and processing system were developed followed by an in vivo evaluation of the technology on seventeen patients undergoing elective laparotomy. Photoplethysmographic (PPG) signals of good quality and high signal-to-noise ratio were obtained from the small bowel, large bowel, liver and stomach. Simultaneous peripheral PPG signals from the finger were also obtained for comparison purposes. Analysis of the amplitudes of all acquired PPG signals indicated much larger amplitudes for those signals obtained from splanchnic organs than those obtained from the finger. Estimated SpO(2) values for splanchnic organs showed good agreement with those obtained from the finger fibre optic probe and those obtained from a commercial device. These preliminary results suggest that a miniaturized 'indwelling' fibre optic sensor may be a suitable method for pre-operative and post-operative evaluation of splanchnic organ SpO(2) and their health.
Asunto(s)
Arterias , Análisis de los Gases de la Sangre , Tecnología de Fibra Óptica , Oximetría/instrumentación , Oxígeno/sangre , Circulación Esplácnica , Femenino , Humanos , Laparotomía , Masculino , PletismografíaRESUMEN
In an attempt to overcome the limitations of current techniques for monitoring abdominal organ perfusion, a prototype reflectance fiber optic photoplethysmographic (PPG) sensor and processing system was evaluated on seventeen anaesthetized patients undergoing laparotomy. Good quality PPG signals were obtained from the large bowel, small bowel, liver and stomach. Simultaneous PPG signals from the finger were also obtained for comparison purposes using an identical fiber optic sensor. Analysis of the mean ac and dc PPG amplitudes of all acquired signals indicated larger amplitudes for those signals obtained from abdominal organs than those obtained from the finger. Mean estimated blood oxygen saturation (SpO(2)) values from all abdominal sites showed good agreement with those obtained from the finger using both the finger fiber optic sensor and a commercial finger pulse oximeter. Furthermore, a Bland and Altman between-method-differences analysis on the estimated SpO(2) data suggests that a fiber optic abdominal sensor may be a suitable method for the evaluation of abdominal organ perfusion.
Asunto(s)
Tecnología de Fibra Óptica/instrumentación , Fotopletismografía/instrumentación , Transductores , Vísceras/fisiología , Velocidad del Flujo Sanguíneo/fisiología , Diseño de Equipo , Análisis de Falla de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Vísceras/irrigación sanguíneaRESUMEN
There is a need for a reliable and continuous monitoring of abdominal organ oxygen saturation (SpO(2)). Splanchnic ischemia may ultimately lead to cellular hypoxia and necrosis and may well contribute to the development of multiple organ failures and increased mortality. A new prototype reflectance fiber optic photoplethysmographic sensor and signal processing system was evaluated on six anaesthetized patients undergoing elective laparotomy. PPG signals were obtained from various organs, including large and small bowel, liver, and stomach. The normalized amplitudes of the splanchnic PPG signals were in good agreement with those obtained from the periphery using an identical fiber optic sensor. Furthermore, average SpO(2) values were in good agreement and showed correlation with those obtained from a commercial system. These preliminary results suggest that a miniaturized 'indwelling' fiber optic sensor may be a suitable method for pre-operative and post-operative evaluation of splanchnic organ SpO(2) and their health.
Asunto(s)
Técnicas Biosensibles , Laparotomía/instrumentación , Fibras Ópticas , Pletismografía/instrumentación , Circulación Esplácnica , ElectrocardiografíaRESUMEN
Primary benign vesical teratomas are rare. Most of the cases reported are paravesical teratomas rupturing into the bladder. A case of primary benign vesical teratoma suspected preoperatively and later confirmed at histopathology is reported.