Intestinal perfusion assessed by quantitative fluorescence angiography in piglets with necrotizing enterocolitis.
J Pediatr Surg
; 57(4): 747-752, 2022 Apr.
Article
em En
| MEDLINE
| ID: mdl-34872732
ABSTRACT
BACKGROUND:
Reduced intestinal perfusion is thought to be a part of the pathogenesis in necrotizing enterocolitis (NEC). This study aims to evaluate the intestinal perfusion assessment in NEC-lesions by quantitative fluorescence angiography with indocyanine green (q-ICG) during laparoscopy and open surgery.METHODS:
Thirty-four premature piglets were delivered by cesarean section and fed with parenteral nutrition and increasing infant formula volumes to induce NEC. During surgery, macroscopic NEC-lesions were evaluated using a validated macroscopic scoring system (1-6 for increasing NEC severity). The intestinal perfusion was assessed by q-ICG and quantified with a validated pixel intensity computer algorithm.RESULTS:
Significantly higher perfusion values were found in healthy areas of the colon (score 1) compared to those with NEC scores of 4, 5, and 6 (p < 0.05). Similarly, in the small intestine, perfusion was higher in the intestine with areas scored 1 compared to scores of 3 and 4 (p < 0.05). A cut-off value was found between NEC score of 1-2 vs. 3-4 for the small intestine at 117 and for colon at 107 between NEC scores 12 vs. scores of 36 with an area less than the curve value at 0.9 (p < 0.05).CONCLUSIONS:
q-ICG seems to be a feasible and valuable technique to evaluate the perfusion of tissue with NEC-lesions. We found a cut-off between intestine with scores 1-2 and intestine with NEC scores 3-6 in colon, and NEC score 3-4 in the small intestine. LEVEL OF EVIDENCE II.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Enterocolite Necrosante
Tipo de estudo:
Etiology_studies
Limite:
Animals
/
Female
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Humans
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Newborn
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Pregnancy
Idioma:
En
Revista:
J Pediatr Surg
Ano de publicação:
2022
Tipo de documento:
Article