Surface oximetry for intraoperative assessment of colonic viability in horses.
Surface oximetry was used to evaluate viability of the ascending colon in 60 horses with naturally occurring colonic volvulus or displacement. Tissue surface oxygen tension (PsO2) was measured on the serosal surface of the pelvic flexure after anatomic correction of the colonic obstruction. Horses with PsO2 > 20 mm of Hg were predicted to have viable colon; whereas, horses with PsO2 < or = 20 mm of Hg were predicted to have nonviable colon. Results of surface oximetry were compared with final outcome. For surface oximetry, sensitivity (ability to accurately identify colon that was nonviable) was 53%, but specificity (ability to accurately identify bowel that was viable) was 100%. Negative predictive value (probability that a horse with PsO2 < or = 20 mm of Hg truly had nonviable bowel) was 87%, and positive predictive value (probability that a horse with PsO2 < or = 20 mm of Hg truly had nonviable bowel) was 100%. The overall accuracy was 88%. Of the 45 horses that had a colonic PsO2 > 20 mm of Hg and survived, 7 had been given, on the basis of subjective assessment of visual criteria, a good prognosis, 28 had been given a guarded prognosis, and 10 had been given a poor prognosis. Of the horses that had a colonic PsO2 > 20 mm of Hg but died after surgery because of further colonic infarction, confirmed at necropsy, 4 had been given a poor prognosis, and 3 had been given a guarded prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Snyder
J R
JR
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis 95616.
Pascoe
J R
JR
Meagher
D M
DM
Thurmond
M C
MC
D000818:Animals; D003106:Colon / Q000737:chemistry / Q000473:pathology / Q000502:physiology*; D003108:Colonic Diseases / Q000601:surgery / Q000662:veterinary*; D005069:Evaluation Studies as Topic; D005260:Female; D006734:Horse Diseases / Q000601:surgery*; D006736:Horses; D007415:Intestinal Obstruction / Q000601:surgery / Q000662:veterinary*; D007430:Intraoperative Care / Q000662:veterinary*; D008297:Male; D010092:Oximetry / Q000662:veterinary; D010100:Oxygen / Q000032:analysis; D011379:Prognosis; D012680:Sensitivity and Specificity
D010100:Oxygen