Abstract
Assessment of microcirculation and tissue perfusion parameters is extremely important during surgical interventions, especially during operations on the brain and abdominal organs. Such a system must be handy, non-invasive, and directly integrated into the surgical workflow. To date, there is no standard procedure for assessing blood circulation in routine clinical practice. All the technical proposals are in the stage of research and development. This paper is discussing features of imaging photoplethysmography (IPPG) application to intraoperative visualization and quantitative assessment of tissue perfusion. Measurement of perfusion using photoplethysmography has been known since the 30s of the last century. Nevertheless, discussions of the physiological model underlying this method are still ongoing. An alternative model of light modulation in interaction with blood vessels in vivo was proposed in our group in 2015. Based on this model, we developed a system of intraoperative visualization of blood flow, which uses only video recording of a tissue under study followed by appropriate data processing. Distinguishing feature of the system is synchronous recording of video frames and electrocardiogram. The developed system allows for contactless monitoring of blood flow in cortex and abdominal organs in real time with high spatial resolution. This report is an overview of recent pilot studies on monitoring blood flow parameters during open brain and abdominal surgeries using the IPPG system. It was demonstrated that the quantitative assessment of blood perfusion by IPPG is in good agreement with that obtained by ICG-fluorescence angiography. IPPG can become an objective quantitative monitoring system for tissue perfusion in the operating room due to its simplicity, low cost and no need for any agent injections.
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This research was financially supported by the Russian Science Foundation (Grant no. 21-15-00265).
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Kamshilin, A.A. Imaging Photoplethysmography as a Reliable Tool for Monitoring Tissue Perfusion during Open Brain and Abdominal Surgeries. Bull. Russ. Acad. Sci. Phys. 86 (Suppl 1), S85–S91 (2022). https://doi.org/10.3103/S1062873822700447
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DOI: https://doi.org/10.3103/S1062873822700447