Myoelectric assessment of bowel viability. 1987

R E Brolin, and J L Semmlow, and R A Koch, and M T Reddell, and B A Mast, and J W Mackenzie

A device capable of quantitative measurement of intestinal ischemic damage has been designed. The device is called the electrical contractility meter and employs a clip-on strain gauge transducer that delivers a precisely controlled electrical stimulus to the bowel. Threshold stimulus level (TSL) is the stimulus current in milliamperes (mA) that is necessary to produce a clearly defined smooth-muscle contraction. In 30 dogs, TSL was used to establish viability boundaries in 40 cm ischemic bowel segments. Bowel viability was assessed with the use of TSL in comparison with gross features (color, peristalsis) and blood flow measured by means of Doppler ultrasound at 2 cm intervals in the ischemic small-bowel segments. The TSL scale ranges to 100 mA and varied from a low of 22 +/- 2 mA in normal bowel outside the ischemic segment to 97 +/- 4 mA in grossly gangrenous bowel. There was a consistent correlation between rising TSL and worsening bowel color, disappearance of visible peristalsis, and progressive disappearance of audible Doppler signals. Resection and anastomosis were performed in three groups of 10 dogs at TSL measurements of 30 mA, 40 mA, and 50 mA, respectively. Dogs were killed and anastomoses were inspected on the tenth postoperative day. There were no leaks at TSL = 30 mA, one leak at TSL = 40 mA, and four leaks at TSL = 50 mA. The number of leaks at TSL = 50 mA was significantly greater than at TSL = 30 mA (p less than 0.04, Fisher's exact test). These results show that the quantitative myoelectric parameters established by this device provide a reliable in vivo assessment of bowel viability. The electrical contractility meter is easy to use and may have clinical applicability.

UI MeSH Term Description Entries
D007421 Intestine, Small The portion of the GASTROINTESTINAL TRACT between the PYLORUS of the STOMACH and the ILEOCECAL VALVE of the LARGE INTESTINE. It is divisible into three portions: the DUODENUM, the JEJUNUM, and the ILEUM. Small Intestine,Intestines, Small,Small Intestines
D007511 Ischemia A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION. Ischemias
D007813 Laparotomy Incision into the side of the abdomen between the ribs and pelvis. Minilaparotomy,Laparotomies,Minilaparotomies
D009119 Muscle Contraction A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. Inotropism,Muscular Contraction,Contraction, Muscle,Contraction, Muscular,Contractions, Muscle,Contractions, Muscular,Inotropisms,Muscle Contractions,Muscular Contractions
D009130 Muscle, Smooth Unstriated and unstriped muscle, one of the muscles of the internal organs, blood vessels, hair follicles, etc. Contractile elements are elongated, usually spindle-shaped cells with centrally located nuclei. Smooth muscle fibers are bound together into sheets or bundles by reticular fibers and frequently elastic nets are also abundant. (From Stedman, 25th ed) Muscle, Involuntary,Smooth Muscle,Involuntary Muscle,Involuntary Muscles,Muscles, Involuntary,Muscles, Smooth,Smooth Muscles
D010528 Peristalsis A movement, caused by sequential muscle contraction, that pushes the contents of the intestines or other tubular organs in one direction. Peristalses
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D004558 Electric Stimulation Use of electric potential or currents to elicit biological responses. Stimulation, Electric,Electrical Stimulation,Electric Stimulations,Electrical Stimulations,Stimulation, Electrical,Stimulations, Electric,Stimulations, Electrical
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D014463 Ultrasonography The visualization of deep structures of the body by recording the reflections or echoes of ultrasonic pulses directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. Echography,Echotomography,Echotomography, Computer,Sonography, Medical,Tomography, Ultrasonic,Ultrasonic Diagnosis,Ultrasonic Imaging,Ultrasonographic Imaging,Computer Echotomography,Diagnosis, Ultrasonic,Diagnostic Ultrasound,Ultrasonic Tomography,Ultrasound Imaging,Diagnoses, Ultrasonic,Diagnostic Ultrasounds,Imaging, Ultrasonic,Imaging, Ultrasonographic,Imaging, Ultrasound,Imagings, Ultrasonographic,Imagings, Ultrasound,Medical Sonography,Ultrasonic Diagnoses,Ultrasonographic Imagings,Ultrasound, Diagnostic,Ultrasounds, Diagnostic

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