Detection of occult XXXX during aortic procedures: use of an intraoperative photoplethysmographic technique.

@entity1 @entity63 @entity26 @entity450 @entity392 @entity694
A photoplethysmographic technique was used in 30 consecutive @entity1 who had abdominal aortic reconstruction to assess @entity694 intraoperatively. A sterile pulse oximeter probe was used to measure arterial @entity392 and transcolonic @entity26 saturation (TCOS) in the proximal, midportion, and distal sigmoid colon before and after the reconstruction. No attempt at inferior mesenteric revascularization was made, irrespective of the photoplethysmographic results. The status of the colon was assessed between the third and sixth postoperative day by a colonoscopist unaware of the intraoperative data. Before the reconstructive procedure photoplethysmography displayed @entity450 in all @entity1 with a mean TCOS of 95% +/- 0.4%. After reconstruction, 28 @entity1 (93%) demonstrated unchanged @entity392 with mean TCOS of 94% +/- 0.4%. Despite ligation of a patent inferior mesenteric artery in 10 of these @entity1 , all 28 had normal colonoscopic examinations. By contrast, two @entity1 (6.7%) had a loss of photoplethysmographic @entity392 with unmeasurable TCOS. Both of these @entity1 had ligation of an initially patent inferior mesenteric artery and demonstrated evidence of @entity63 mucosal changes at colonoscopy. Intraoperative colonic photoplethysmography represents an easily performed, accurate method for predicting @entity694 . A loss of @entity392 suggests inadequate postreconstructive colonic perfusion and mandates revascularization of the inferior mesenteric artery.
