title: Anastomotic leak detection by electrolyte electrical resistance.
abstract: OBJECTIVE
  To characterize a new method of postoperative gastrointestinal leak detection based on electrical resistance changes due to extravasated electrolyte contrast.
  
  
  BACKGROUND
  Postoperative gastrointestinal leak results in increased patient morbidity, mortality, and hospital costs that can be mitigated by early diagnosis. A sensitive and specific diagnostic test that could be performed at the bedside has the potential to shorten the time to diagnosis and thereby improve the quality of treatment.
  
  
  METHODS
  Anaesthetized rats underwent celiotomy and creation of a 5-mm gastrotomy. In experimental animals, electrical resistance changes were measured with a direct current ohmmeter after the introduction of 5 cc of 23.4% NaCl electrolyte solution via gavage and measured with a more sensitive alternating current ohmmeter after the gavage of 1-5 cc of 0.9% NaCl. Comparison was made to negative controls and statistical analysis was performed.
  
  
  RESULTS
  Leakage from the gastrotomy induced by as little as 1 cc of gavage-delivered 0.9% NaCl contrast solution was detectable as a statistically significant drop in electrical resistance when compared to results from negative controls.
  
  
  CONCLUSIONS
  Electrical resistance change associated with electrolyte-gated leak detection is highly sensitive and specific and has the potential to be rapidly translated into clinical settings.
authors.affiliation: Department of Surgery, Division of Thoracic Surgery, University of Texas Health Science Center, San Antonio, Texas 78229, USA. dearmond@uthscsa.edu
authors.forename: Daniel T
authors.initials: DT
authors.lastname: DeArmond
authors.forename: Adam M
authors.initials: AM
authors.lastname: Cline
authors.forename: Scott B
authors.initials: SB
authors.lastname: Johnson
mesh_terms: D000714:Anastomosis, Surgical; D057868:Anastomotic Leak / Q000175:diagnosis*; D000818:Animals; D017097:Electric Impedance; D004573:Electrolytes; D005119:Extravasation of Diagnostic and Therapeutic Materials; D023421:Models, Animal; D011183:Postoperative Complications; D051381:Rats; D011914:Rats, Inbred BN; D012680:Sensitivity and Specificity; D012965:Sodium Chloride
chemical_list: D004573:Electrolytes; D012965:Sodium Chloride