Skip to main content

Continuous intraoperative monitoring of hepatic blood perfusion using a noninvasive surface electrode

Digestive Diseases and Sciences volume 35, pages 399–405 (1990)Cite this article

Abstract

Continuous noninvasive measurement of local blood flow at one or more chosen sites will be useful during experiments on the liver, during liver surgery, or after hepatic transplantation. We have compared a Clark-type flow-dependent oxygen electrode having a 3-mm-diameter cathode applied to the surface of rabbit liver to an electromagnetic flowmeter (EMF) on the portal vein. Reduction in portal flow (ranging from 4 to 100% and maintained over 2 min), correlated with reduction in electrode output (r=0.944, P< 0.001). Electrode output was independent of systemic arterial Po2 (ranging from 85 to 340 mm Hg) (P>0.99) and thus of oxygen in inspired gases. These results indicate that this electrode gives a continuous indication of portal venous inflow when hepatic central inflow is undisturbed and may thus prove to be a useful tool in the clinical assessment of liver perfusion.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Richardson PDI, Withrington PG: Liver blood flow. I. Intrinsic and nervous control of liver blood flow. Gastroenterology 81:159–173, 1981

    PubMed  Google Scholar 

  2. Gessner U: Effects of the vessel wall on electromagnetic flow measurement. Biophys J 1:627–637, 1961

    PubMed  Google Scholar 

  3. O'Sullivan VT: Effect of blood vessels on electromagnetic flowmeter sensitivity. Phys Med Biol 27:277–284, 1982

    PubMed  Google Scholar 

  4. Price JB, Britton R, Peterson LM, Reilly JW, Voorhees AB: The validity of chronic hepatic blood flow measurements obtained by the electromagnetic flow meter. J Surg Res V(7):313–317, 1965

    Google Scholar 

  5. Wyatt DG: Review: Blood flow velocity measurementin vivo by electromagnetic induction. Med Biol Eng Comput 22:193–211, 1984

    PubMed  Google Scholar 

  6. Taylor KJW: Blood flow in deep abdominal and pelvic vessels: Ultrasonic pulsed Doppler analysis. Radiology 154:487–493, 1985

    PubMed  Google Scholar 

  7. Griffin DR, Teague MJ, Tallet P, Willson K, Bilardo C, Massini L, Campbells: A combined ultrasonic linear arrary scanner and pulsed Doppler velocimeter for the estimation of blood flow in the foetus and adult abdomen—II: Clinical evaluation. Ultrasound Med Biol 11(1):37–41, 1985

    PubMed  Google Scholar 

  8. Burns PN: The physical principles of doppler and spectral analysis. J Clin Ultrasound 15:567–590, 1987

    Google Scholar 

  9. van Merode T, Hick P, Hoeks APG, Reneman RS: Limitations of Doppler spectral broadening in the early detection of carotid artery disease due to the size of the sample volume. Ultrasound Med Biol 9:581–586, 1983

    PubMed  Google Scholar 

  10. Vorobioff J, Bredfeldt JE, Groszmann RJ: Increase blood flow through the portal system in cirrhotic rats. Gastroenterology 87:1120–1126, 1984

    PubMed  Google Scholar 

  11. Buckberg GD, Luck JC, Payne DB, Hoffman JIE, Archie JP, Fixier DE: Some sources of error in measuring regional blood flow with radioactive microspheres. J Appl Physiol 31:598–604, 1971

    PubMed  Google Scholar 

  12. Fleming JS, Ackery D, Walmsley BH, Karran SJ: Scintigraphic estimation of arterial and portal blood supplies to the liver. J Nucl Med 24:1108–1113, 1983

    PubMed  Google Scholar 

  13. Gouma DJ, Coelho CU, Schlegel J, Fisher JD, Li YF, Moody FG: Estimation of hepatic blood flow by hydrogen gas clearance. Surgery April:439–445, 1986

    Google Scholar 

  14. Baumberger JP, Goodfriend RB: Determination of arterial oxygen tension in man by equilibration through intact skin. Fed Proc 10:10–11, 1951

    Google Scholar 

  15. Clark LC: Monitor and control of blood and tissue oxygen tension. Trans Am Soc Artif Intern Organ 2:41–48, 1956

    Google Scholar 

  16. Hunt TK, Robkin J, Jensen JA, Jonsson K, Smitten KV, Goodson WH: Tissue oximetry: An interim report. Word J Surg 11:126–132, 1987

    Google Scholar 

  17. Hahn CE: Blood gas measurement. Clin Phys Physiol Meas 8:1–38 1987

    PubMed  Google Scholar 

  18. Bland JM, Altman DG: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 8:307–310, 1986

    Google Scholar 

  19. Guyton AC: Textbook of Medical Physiology. Philadelphia, WB Saunders, 1986, pp 495–496

    Google Scholar 

  20. Schuler R, Kreuzer F: Rapid polarographicin vivo oxygen catheter electrodes. Respir Physiol 3:90–110, 1967

    PubMed  Google Scholar 

  21. Piasecki C: First experimental results with the oxygen electrode as a local blood flow sensor in canine colon. Br J Surg 72:452–453, 1985

    PubMed  Google Scholar 

  22. Shandall A, Lowndes R, Young HL: Colonic anastomotic healing and oxygen tension. Br J Surg 72:606–609, 1985

    PubMed  Google Scholar 

  23. Sheridan WG, Lowndes RF, Young HL: Tissue oximetry as an assessment of perfusion in the human gastrointestinal tract.In Blood Flow Measurement in Clinical Diagnosis. R Price, JA Evans (eds). Biological Engineering Society, Conference Proceedings 1988, 4:130–137

  24. Locke R, Hauser CJ, Shoemaker WC: The use of surface oximetry to assess bowel viability. Arch Sury 119:1252–1256, 1984

    Google Scholar 

  25. Kram HB, Shoemaker WC: Method for intraoperative assessment of organ perfusion and viability using a miniature oxygen sensor. Am J Surg 148:404–407, 1984

    PubMed  Google Scholar 

  26. Piasecki C: A new method for the assessment of gut viability. Br J Surg 68:319–322, 1981

    PubMed  Google Scholar 

  27. Ji S, Lemasters JJ, Christenson V, Thurman RG: Selective increase in pericentral oxygen gradient in perfused rat liver following ethanol treatment. Pharmacol Biochem Behav 19:439–442, 1983

    Google Scholar 

  28. Sherlock S: Diseases of the Liver and Biliary System. Oxford, Blackwell Scientific, 1985, pp 182–183

    Google Scholar 

  29. Tygstrup N, Winkler K, Mellemgaard K, Andreassen M: Determination of the hepatic arterial blood flow and oxygen supply in man by clamping the hepatic artery during surgery. J Clin Invest 41:447–454, 1962

    PubMed  Google Scholar 

  30. Rappaport AM. Physioanatomic considerations:In Diseases of the Liver. E Shiff, L Shiff (eds). Philadelphia, JB Lippincott 1987, pp 14–21

    Google Scholar 

  31. Hanna SS: Effect of portal vein occlusion on liver blood flow in normal and cirrhotic dogs. J Surg Res 41:293–300, 1986

    PubMed  Google Scholar 

  32. Lautt WW: Effect of stimulation of hepatic nerves on hepatic O2 uptake and blood flow. Am J Physiol 232(6):H652-H656, 1977

    PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Anatomy, Royal Free Hospital School of Medicine, Pond Street, NW3 2PF, London, England

    C. Piasecki MB, BS, PhD & A. M. Seifalian MSc

  2. Academic Department of Surgery, Royal Free Hospital School of Medicine, NW3 2PF, London, England

    C. Piasecki MB, BS, PhD & A. M. Seifalian MSc

Authors
  1. C. Piasecki MB, BS, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. M. Seifalian MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This study was supported by Peter Samual Royal Free Grant No. 764.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Piasecki, C., Seifalian, A.M. Continuous intraoperative monitoring of hepatic blood perfusion using a noninvasive surface electrode. Digest Dis Sci 35, 399–405 (1990). https://doi.org/10.1007/BF01537421

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01537421

Key words

  • Blood flow
  • liver
  • oxygen electrode
  • instrumentation
  • electromagnetic flowmeter
  • portal blood flow