The use of photoplethysmography and Doppler ultrasound to predict anastomotic viability after segmental intestinal ischaemia in dogs.
OBJECTIVE
To compare photoplethysmography and Doppler ultrasonography in the prediction of the viability of experimental jejunoileal anastomoses in the presence of arterial (n = 11), venous (n = 11), and mixed arterial and venous (n = 9) segmental ischaemia.


METHODS
Experimental open study.


METHODS
31 Mongrel dogs.


METHODS
Laparotomy, selective devascularisation, and anastomosis. In 20 of the experiments a bolus injection of papaverine was given into the superior mesenteric artery. Second laparotomy on day 15, or earlier if indicated.


METHODS
Correlation between photoplethysmography, Doppler ultrasonography, and macroscopic and histological findings.


RESULTS
All non-viable anastomoses had photoplethysmographic wave amplitudes of less than 10% of the control value, with sensitivity and specificity of 100%. Venous volume and maximum venous outflow had a sensitivity of 72% and a specificity of 77%. Doppler ultrasonography had a sensitivity of 100%, but a specificity of only 67%. Papaverine had no effect on photoplethysmographic wave amplitude in these experiments.


CONCLUSIONS
Photoplethysmography is the preferred method of assessing intestinal viability in the presence of ischaemia.
Alós
R
R
Department of Surgery, Clinic Hospital, University of Valencia, Spain.
Garcia-Granero
E
E
Calvete
J
J
Uribe
N
N
D000714:Anastomosis, Surgical; D000818:Animals; D001158:Arteries; D004285:Dogs; D007082:Ileum / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology / Q000601:surgery*; D007269:Injections, Intra-Arterial; D007511:Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007583:Jejunum / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology / Q000601:surgery*; D010208:Papaverine / Q000008:administration & dosage / Q000494:pharmacology; D017156:Photoplethysmography; D012039:Regional Blood Flow / Q000187:drug effects / Q000502:physiology; D012680:Sensitivity and Specificity; D014022:Tissue Survival; D014463:Ultrasonography; D014680:Veins
D010208:Papaverine