Evaluation of endoscopic visible light spectroscopy: comparison with microvascular oxygen tension measurements in a porcine model - PubMed Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb 28;17(1):65.
doi: 10.1186/s12967-019-1802-x.

Evaluation of endoscopic visible light spectroscopy: comparison with microvascular oxygen tension measurements in a porcine model

Rinse Ubbink  1 , Louisa J D van Dijk  2   3 , Desirée van Noord  4   5 , Tanja Johannes  1 , Patricia A C Specht  1 , Marco J Bruno  4 , Egbert G Mik  1   6
Affiliations

Evaluation of endoscopic visible light spectroscopy: comparison with microvascular oxygen tension measurements in a porcine model

Rinse Ubbink et al. J Transl Med. .

Abstract

Background: Visible light spectroscopy (VLS) is a technique used to measure the mucosal oxygen saturation during upper gastrointestinal endoscopy to evaluate mucosal ischemia, however in vivo validation is lacking. We aimed to compare VLS measurements with a validated quantitative microvascular oxygen tension (μPO2) measurement technique.

Methods: Simultaneous VLS measurements and μPO2 measurements were performed on the small intestine of five pigs. First, simultaneous measurements were performed at different FiO2 values (18%-100%). Thereafter, the influence of bile was assessed by comparing VLS measurements in the presence of bile and without bile. Finally, simultaneous VLS and μPO2 measurements were performed from the moment a lethal dose potassium chloride intravenously was injected.

Results: In contrast to μPO2 values that increased with increasing FiO2, VLS values decreased. Both measurements correlated poorly with R2 = 0.39, intercept 18.5, slope 0.41 and a bias of - 16%. Furthermore, the presence of bile influenced VLS values significantly (median (IQR)) before bile application 57.5% (54.8-59.0%) versus median with bile mixture of the stomach 73.5% (66.8-85.8), p = < 2.2 * 10-16; median with bile mixture of small bowel 47.6% (41.8-50.8) versus median after bile removal 57.0% (54.7-58.6%), p = < 2.2 * 10-16). Finally, the VLS mucosal oxygen saturation values did not decrease towards a value of 0 in the first 25 min of asystole in contrast to the μPO2 values.

Conclusions: These results suggest that VLS measures the mixed venous oxygen saturation rather than mucosal capillary hemoglobin oxygen saturation. Further research is needed to establish if the mixed venous compartment is optimal to assess gastrointestinal ischemia.

Keywords: Chronic mesenteric ischemia; Diagnostics; Microvascular oxygen tension measurements; Visible light spectroscopy.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Set-up of the experiment of the VLS-probe (blue) and the μPO2 probe fixated together positioned 1 to 5 mm above the mucosa of the small intestinal loop
Fig. 2
Fig. 2
Conversion of μPO2 into saturation according to the found relationship by Serianni et al. [23]
Fig. 3
Fig. 3
Scatter plot n = 5 of mucosal oxygen saturation versus μPO2 measurements at different FiO2 values. VLS (R2 = − 0.01, Intersect = 42.19, Slope = − 0.07), μPO2 (R2 = 0.06, intersect = 35.56, slope = 0.14)
Fig. 4
Fig. 4
a Correlation between mucosal oxygen saturation and the converted μPO2 saturation. R2 = 0.39, intercept 18.5 slope 0.41. b Blant–Altman plot of the mucosal oxygen saturation and the converted μPO2 saturation. VLS—μPO2_saturation: − 16.00974, 2.5% limit: − 52.83358, 97.5% limit: 20.81410, SD (diff): 18.41192
Fig. 5
Fig. 5
Mucosal oxygen saturation measurements without the presence of bile, with the presence of a bile mixture from the stomach, with a bile mixture from the small bowel and measurements without any of the bile mixtures. The baseline mucosal oxygen saturations did not significantly differ from the mucosal oxygen saturations after the bile had been removed shown as “after bile”. ***p < 2.2 * 10−16
Fig. 6
Fig. 6
Average mucosal oxygen saturation measurements measured by VLS (black) over 21 data points (gray) and μPO2 measurements (red) during the minimally first 20 min of asystole in 5 pigs. Green vertical dashed line represents the time a lethal potassium dose was injected
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Benaron DA, Parachikov IH, Cheong WF, Friedland S, Rubinsky BE, Otten DM, et al. Design of a visible-light spectroscopy clinical tissue oximeter. J Biomed Opt. 2005;10(4):44005. doi: 10.1117/1.1979504. - DOI - PubMed
    1. Friedland S, Soetikno R, Benaron D. Reflectance spectrophotometry for the assessment of mucosal perfusion in the gastrointestinal tract. Gastrointest Endosc Clin N Am. 2004;14(3):539–553. doi: 10.1016/j.giec.2004.03.011. - DOI - PubMed
    1. Friedland S, Benaron D, Coogan S, Sze DY, Soetikno R. Diagnosis of chronic mesenteric ischemia by visible light spectroscopy during endoscopy. Gastrointest Endosc. 2007;65(2):294–300. doi: 10.1016/j.gie.2006.05.007. - DOI - PubMed
    1. Van Noord D, Sana A, Benaron DA, Pattynama PM, Verhagen HJ, Hansen BE, et al. Endoscopic visible light spectroscopy: a new, minimally invasive technique to diagnose chronic GI ischemia. Gastrointest Endosc. 2011;73(2):291–298. doi: 10.1016/j.gie.2010.10.025. - DOI - PubMed
    1. Writing C, Bjorck M, Koelemay M, Acosta S, Bastos Goncalves F, Kolbel T, et al. Editor’s choice—management of the diseases of mesenteric arteries and veins: clinical practice guidelines of the european society of vascular surgery (ESVS) Eur J Vasc Endovasc Surg. 2017;53(4):460–510. doi: 10.1016/j.ejvs.2017.01.010. - DOI - PubMed