Immediate alterations in intestinal oxygen saturation and blood flow after massive small bowel resection as measured by photoacoustic microscopy

• Published in: Journal of pediatric surgery 2012-06, Vol.47 (6), p.1143-1149
• Main Authors: Rowland, Kathryn J, Yao, Junjie, Wang, Lidai, Erwin, Christopher R, Maslov, Konstantin I, Wang, Lihong V, Warner, Brad W
• Format: Article
• Language: English
• Subjects: Adaptation, Physiological; Animals; Arterioles; Blood flow; Ileum - blood supply; Ileum - chemistry; Ileum - diagnostic imaging; Ileum - surgery; Male; Mesenteric Veins; Mice; Mice, Inbred C57BL; Microcirculation; Microscopy - methods; Microvessels - diagnostic imaging; Microvessels - ultrastructure; Oximetry - instrumentation; Oximetry - methods; Oxygen - analysis; Oxygen - pharmacokinetics; Oxygen saturation; Oxyhemoglobins - analysis; Pediatrics; Photoacoustic microscopy; Photoacoustic Techniques; SBR; Short Bowel Syndrome - etiology; Short Bowel Syndrome - physiopathology; Small bowel resection; Splanchnic Circulation; Surgery; Ultrasonography
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2012.03.020

Abstract Purpose Massive small bowel resection (SBR) results in villus angiogenesis and a critical adaptation response within the remnant bowel. Previous ex vivo studies of intestinal blood flow after SBR are conflicting. We sought to determine the effect of SBR on intestinal hemodynamics using photoacoustic microscopy, a noninvasive, label-free, high-resolution in vivo hybrid imaging modality. Methods Photoacoustic microscopy was used to image the intestine microvascular system and measure blood flow and oxygen saturation (S o2 ) of the terminal mesenteric arteriole and accompanying vein in C57BL6 mice (n = 7) before and immediately after a 50% proximal SBR. A P value of less than .05 was considered significant. Results Before SBR, arterial and venous S o2 were similar. Immediately after SBR, the venous S o2 decreased with an increase in the oxygen extraction fraction. In addition, the arterial and venous blood flow significantly decreased. Conclusion Massive SBR results in an immediate reduction in intestinal blood flow and increase in tissue oxygen utilization. These physiologic changes are observed throughout the remnant small intestine. The contribution of these early hemodynamic alterations may contribute to the induction of villus angiogenesis and the pathogenesis of normal intestinal adaptation responses.