Skip to main content
Log in

Use of the Liver Tissue Oxygenation Index as a Noninvasive Parameter of Intestinal Ischemia in Rabbits

  • Published:
World Journal of Surgery Aims and scope Submit manuscript



The tissue oxygenation index (TOI), measured by spatially resolved spectroscopy (SRS), reflects the ratio between oxygenated and deoxygenated tissue hemoglobin. We investigated whether liver TOI is a noninvasive parameter for early detection of intestinal ischemia.


In seven adult New Zealand rabbits the superior mesenteric artery (SMA) and vein were exposed by laparotomy. The SRS probe was attached at the skin above the liver to calculate the TOI. The bowel (SbO2) and peripheral (SpO2) oxygen saturation were continuously measured. The SMA was occluded, creating small bowel ischemia for 90 minutes. Then reperfusion was started for 1 hour. The median TOI and interquartile range (IQR) of the TOI were calculated. A paired Wilcoxon test was used to evaluate changes in the liver TOI and SpO2 during ischemia and reperfusion.


The median TOI was 54.3% (IQR 8) at the start of ischemia, 54.9% (IQR 9) after 30 minutes, 51% (IQR 11) after 60 minutes, and 50.3% (IQR 10) after 90 minutes. The median TOI values were 46.3% (IQR 5) after 30 minutes of reperfusion and 41.2% (IQR 5) after 60 minutes. The decrease in TOI became significant (p < 0.05) after 90 minutes of ischemia. The SpO2 was stable during the experiment.


A significant decrease in liver TOI was seen after 90 minutes of occlusion of the SMA and is likely to be the consequence of bowel ischemia. The further decrease after reperfusion might reflect reperfusion injury. Liver TOI may be a new tool for noninvasive early detection of intestinal ischemia and reperfusion. Further study is needed to confirm these findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others


  1. Litwin A, Avidor I, Schujman E, et al. (1984) Neonatal intestinal perforation caused by congenital defects of the intestinal musculature. Am J Clin Pathol 81(1):77–80

    PubMed  CAS  Google Scholar 

  2. Miserez M, Barten S, Geboes K, et al. (2003) Surgical therapy and histological abnormalities in functional isolated small bowel obstruction and idiopathic gastrointestinal perforation in the very low birth weight infant. World J Surg 27(3):350–355

    Article  PubMed  Google Scholar 

  3. Heys SD, Brittenden J, Crofts TJ (1993) Acute mesenteric ischemia: the continuing difficulty in early diagnosis. Postgrad Med J 69(807):48–51

    Article  PubMed  CAS  Google Scholar 

  4. Matcher J, Kirckpatrick JP, Nahid K, et al. (1995) Absolute quantification methods in tissue near infrared spectroscopy. Proc SPIE 2389:486–495

    Article  Google Scholar 

  5. Suzuki S, Takasaki S, Ozaki T, et al. (1991) A tissue oxygenation monitor using NIR spatially resolved spectroscopy. Proc SPIE 3597:582–592

    Article  Google Scholar 

  6. Naulaers G, Morren G, Van Huffel S, et al. (2002) Cerebral tissue oxygenation index in very premature infants. Arch Dis Child Fetal Neonatal Ed 87(3):F189–F192

    Article  PubMed  CAS  Google Scholar 

  7. Naulaers G, Morren G, Van Huffel S, et al. (2003) Measurement of tissue oxygenation index during the first three days in premature born infants. Adv Exp Med Biol 510:379–383

    PubMed  Google Scholar 

  8. El Desoky E, Seifalian A, Cope M, et al. (1999) Changes in tissue oxygenation of the porcine liver measured by near-infrared spectroscopy. Liver Transpl Surg 5(3):219–226

    Article  PubMed  CAS  Google Scholar 

  9. Petros AJ, Heys R, Tasker RC, et al. (1999) Near infrared spectroscopy can detect changes in splanchnic oxygen delivery in neonates during apnoeic episodes. Eur J Pediatr 158(2):173–174

    Article  PubMed  CAS  Google Scholar 

  10. Schulz G, Weiss M, Bauersfeld U, et al. (2002) Liver tissue oxygenation as measured by near-infrared spectroscopy in the critically ill child in correlation with central venous oxygen saturation. Intensive Care Med 28(2):184–189

    Article  PubMed  Google Scholar 

  11. Teller J, Schwendener K, Wolf M, et al. (2000) Continuous monitoring of liver oxygenation with near infrared spectroscopy during naso-gastric tube feeding in neonates. Schweiz Med Wochenschr 130(18):652–656

    PubMed  CAS  Google Scholar 

  12. Naulaers G, Meyns B, Miserez M, et al. (2005) Measurement of the liver tissue oxygenation by near-infrared spectroscopy. Intensive Care Med 31(1):138–141

    Article  PubMed  Google Scholar 

  13. van Bel F, van Zwieten PH, Guit GL, et al. (1990) Superior mesenteric artery blood flow velocity and estimated volume flow: duplex Doppler US study of preterm and term neonates. Radiology 174(1):165–169

    PubMed  Google Scholar 

  14. Fortune PM, Wagstaff M, Petros AJ (2001) Cerebro-splanchnic oxygenation ratio (CSOR) using near infrared spectroscopy may be able to predict splanchnic ischemia in neonates. Intensive Care Med 27(8):1401–1407

    Article  PubMed  CAS  Google Scholar 

  15. Tokuka A, Tanaka A, Kitai T, et al. (1994) Interrelationship of oxygen supply by hepatic artery and portal vein: rapid analysis of ischemia-reflow-induced changes in hepatic oxygenation in experimental and clinical subjects by tissue near-infrared spectroscopy. Eur Surg Res 26(6):342–352

    PubMed  CAS  Google Scholar 

  16. Turnage RH, Kadesky KM, Myers SI, et al. (1996) Hepatic hypoperfusion after intestinal reperfusion. Surgery 119(2):151–160

    Article  PubMed  CAS  Google Scholar 

  17. Angelelli G, Scardapane A, Memeo M, et al. (2004) Acute bowel ischemia: CT findings. Eur J Radiol 50(1):37–47

    Article  PubMed  Google Scholar 

Download references


This research was sponsored by the Flemish Government (FWO project G.0519.06) and by the Marie-Margueritte Delacroix Foundation.

Author information

Authors and Affiliations


Corresponding author

Correspondence to J. Vanderhaegen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vanderhaegen, J., Dehing, L., Naulaers, G. et al. Use of the Liver Tissue Oxygenation Index as a Noninvasive Parameter of Intestinal Ischemia in Rabbits. World J Surg 31, 2359–2362 (2007).

Download citation

  • Published:

  • Issue Date:

  • DOI: