Qualitative and quantitative fluorescein fluorescence in determining intestinal viability

Area of Science:

• Surgical Research
• Medical Diagnostics
• Vascular Surgery

Background:

• Assessing intestinal viability is critical in cases of temporary arterial occlusion followed by revascularization.
• Clinical evaluation and fluorescence methods are used, but their reliability varies.

Purpose of the Study:

• To compare the effectiveness of clinical evaluation, qualitative fluorescence, and quantitative fluorescence in predicting intestinal viability in an animal model.

Main Methods:

• An animal model of temporary arterial occlusion with early revascularization was used.
• Intestinal viability was assessed using clinical evaluation, visual (qualitative) fluorescence under a Wood's lamp, and quantitative fluorescence with a perfusion fluorometer after fluorescein injection.

Main Results:

• All methods demonstrated 100% specificity in identifying nonviable bowel.
• Quantitative fluorescence showed 100% sensitivity, while clinical evaluation (33%) and qualitative fluorescence (11%) had significantly lower sensitivity.
• Qualitative fluorescence was unreliable due to hyperfluorescence in ischemic bowel that later became necrotic; quantitative fluorometry correctly identified viable segments.

Conclusions:

• Quantitative fluorometric fluorescence is a highly reliable method for assessing intestinal viability after early revascularization.
• Qualitative (visual) fluorescence assessment is not reliable for predicting intestinal viability in this context.