Assessing Ischemic Injury in Human Intestine Ex Vivo with Electrical Impedance Spectroscopy

Electrical impedance spectroscopy is a well-established tool for monitoring changes in the electrical properties of tissue. Most tissue and organ types have been investigated in various studies. As for the small intestine, there are several published studies conducted on pig and rat models. This study investigates the changes in passive electrical properties of the complete wall of the human intestine non-invasively during ischemia. We aim to use the passive electrical properties to assess intestinal viability. The bioimpedance measurements were performed using a two-electrode set-up with a Solartron 1260 Impedance/gain-phase analyser. The small intestinal samples were resected from patients who underwent pancreaticoduodenectomy. Impedance measurements were conducted following resection by placing the electrodes on the surface of the intestine. A voltage was applied across the intestinal sample and the measured electrical impedance was obtained in the ZPlot software. Impedance data were further fitted into a Cole model to obtain the Cole parameters. The P value was calculated from the extracted Cole parameters and used to assess the cell membrane integrity, thus evaluate the intestinal viability. Eight small intestinal segments from different patients were used in this study and impedance measurements were performed once an hour for a ten-hour period. One hour after resection, the impedance decreased, then increased the next two hours, before decreasing until the end of the experiment. For all the intestinal segments, the P values first increased and reached a plateau which lasted for 1 - 2 hours, before it decreased irreversibly. The time interval where P value reached the maximum is consistent with reported viable/non-viable limits from histological analysis.