Time-course evaluation of intestinal structural disorders in a porcine model of intra-abdominal hypertension by mechanical intestinal obstruction

[Etiology and pathogenesis of infected pancreatic necrosis]

Modern literature data confirm the central role of intestinal barrier complex not only as a target in acute necrotizing pancreatitis, but also as a trigger for septic complications. Intra-abdominal hypertension, endothelial dysfunction and gut microbiome changes following necrotizing pancreatitis might have an independent impact on acute intestinal distress syndrome and bacterial translocation. Monitoring of these conditions and early target therapy can improve the outcomes in patients with severe acute pancreatitis. Adverse outcomes of infected pancreatic necrosis including high mortality and morbidity are largely due to the prevalence of multidrug-resistant bacterial pathogens.

Usefulness of a finger-mounted tissue oximeter with near-infrared spectroscopy for evaluating the intestinal oxygenation and viability in rats

PURPOSE

To investigate the utility of the device for evaluating intestinal oxygenation and viability using an animal model.

METHODS

Sprague-Dawley rats underwent laparotomy under general anesthesia, and the blood vessels in the terminal ileum were clamped to create ischemia. We measured the regional tissue oxygenation saturation (rSO2) using an oximeter after 1, 3, and 6 h of vessel clamping. Ischemic tissue damage was assessed using a histological score. The intestine was reperfused after each clamping period, and intestinal rSO2 and survival rate were evaluated.

RESULTS

When reperfusion was performed at 1 and 3 h after ischemia, rSO2 increased after 10 min, and it improved to the same level as for normal intestine after 1 h; all rats survived for 1 week. In contrast, after 6 h of ischemia, rSO2 did not increase after reperfusion, and all animals died within 2 days. The histological scores increased after 1 h of reperfusion, with longer clamping periods.

CONCLUSION

A finger-mounted tissue oximeter could evaluate intestinal ischemia and the viability, which is thus considered to be a promising result for future clinical application.

An Ingestible Electronics for Continuous and Real-Time Intraabdominal Pressure Monitoring

Abdominal compartment syndrome can be treated through decompressive surgery if intraabdominal hypertension (IAH) can be detected in time. Treatment delays due to manual, conventional intravesical pressure (IVP) monitoring using a Foley catheter have been reported. In this work, we present an innovative gastrointestinal intraluminal pressure (GIP) measurement-based method to monitor and improve pressure-guided relief of intraabdominal pressure (IAP). A novel algorithm for detecting IAH in the gastrointestinal tract of a live porcine model is reported. A wireless pressure-sensing capsule (10 × 13 mm) was developed for absolute measurement. The IAP was estimated during artificial pneumoperitoneum. The pressure waveform-based measurements indicated that the wireless pressure sensor could be used to predict IAP. To enhance GIP monitoring for predicting IAH, the proposed continuous ingestible wireless electronics-based pressure waveform measurement device can be used as a complement to existing modalities. The use of the proposed pressure measurement and communication technology can help provide valuable data for digital health platforms.