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. 2012 Jun;47(6):1143-9.
doi: 10.1016/j.jpedsurg.2012.03.020.

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

Kathryn J Rowland  1 , Junjie Yao, Lidai Wang, Christopher R Erwin, Konstantin I Maslov, Lihong V Wang, Brad W Warner
Affiliations

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

Kathryn J Rowland et al. J Pediatr Surg. 2012 Jun.

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 (So(2)) 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 So(2) were similar. Immediately after SBR, the venous So(2) 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.

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Figures

Figure 1
Figure 1
Schematic of the VC-PAM system and experimental setup. Short laser pulses are focused on the exposed bowel through optical lenses and a homemade photoacoustic beam splitter. Ultrasound signal is collected through an acoustic lens, and the beam splitter. The entire photoacoustic probe (enclosed with dashed square) is attached on to a voice-coil stage and stepper motor stage for raster scanning.
Figure 2
Figure 2
Oxygen saturation (sO2) of the terminal mesenteric arteriole (A) and accompanying vein (B) pre-operatively, post-sham (bowel transection alone), and post-SBR at a location 6 cm from the ileal-cecal junction. Asterisk indicates p < 0.05 as compared to pre-op (pre-op vs sham and pre-op vs SBR). Number sign indicates p < 0.05 sham vs SBR.
Figure 2
Figure 2
Oxygen saturation (sO2) of the terminal mesenteric arteriole (A) and accompanying vein (B) pre-operatively, post-sham (bowel transection alone), and post-SBR at a location 6 cm from the ileal-cecal junction. Asterisk indicates p < 0.05 as compared to pre-op (pre-op vs sham and pre-op vs SBR). Number sign indicates p < 0.05 sham vs SBR.
Figure 3
Figure 3
Photoacoustic microscopy images of intestinal microvascular structure and arterial and venous oxygen saturation (sO2) pre-operatively and post-SBR.
Figure 4
Figure 4
Tissue oxygen utilization pre-operatively, post-sham, and post-SBR at a location 6 cm from the ileal-cecal junction as calculated by the oxygen extraction fraction. Asterisk indicates p < 0.05 as compared to pre-op (pre-op vs sham and pre-op vs SBR). Number sign indicates p < 0.05 sham vs SBR.
Figure 5
Figure 5
Blood flow (mm/second) of the terminal mesenteric arteriole (A) and accompanying vein (B) pre-operatively, post-sham, and post-SBR at a location 6 cm from the ileal-cecal junction. Asterisk indicates p < 0.05 as compared to pre-op (pre-op vs sham and pre-op vs SBR). Number sign indicates p < 0.05 sham vs SBR.
Figure 5
Figure 5
Blood flow (mm/second) of the terminal mesenteric arteriole (A) and accompanying vein (B) pre-operatively, post-sham, and post-SBR at a location 6 cm from the ileal-cecal junction. Asterisk indicates p < 0.05 as compared to pre-op (pre-op vs sham and pre-op vs SBR). Number sign indicates p < 0.05 sham vs SBR.
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References

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