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Research Papers: Sensing

Intestinal perfusion monitoring using photoplethysmography

[+] Author Affiliations
Tony J. Akl, Gerard L. Coté

Texas A&M University, Department of Biomedical Engineering, 5045 Emerging Technologies Building, 3120 TAMU, College Station, Texas 77843-3120

Mark A. Wilson

University of Pittsburgh, Department of Surgery, 200 Lothrop Street, Pittsburgh, Pennsylvania 15213

Veterans Affairs Healthcare System, University Drive C-1w142, Pittsburgh, Pennsylvania 15240

M. Nance Ericson

Oak Ridge National Laboratory, P.O. Box 2008, MS 6006, Oak Ridge, Tennessee 37831-6006

J. Biomed. Opt. 18(8), 087005 (Aug 12, 2013). doi:10.1117/1.JBO.18.8.087005
History: Received May 6, 2013; Revised July 15, 2013; Accepted July 16, 2013
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Abstract.  In abdominal trauma patients, monitoring intestinal perfusion and oxygen consumption is essential during the resuscitation period. Photoplethysmography is an optical technique potentially capable of monitoring these changes in real time to provide the medical staff with a timely and quantitative measure of the adequacy of resuscitation. The challenges for using optical techniques in monitoring hemodynamics in intestinal tissue are discussed, and the solutions to these challenges are presented using a combination of Monte Carlo modeling and theoretical analysis of light propagation in tissue. In particular, it is shown that by using visible wavelengths (i.e., 470 and 525 nm), the perfusion signal is enhanced and the background contribution is decreased compared with using traditional near-infrared wavelengths leading to an order of magnitude enhancement in the signal-to-background ratio. It was further shown that, using the visible wavelengths, similar sensitivity to oxygenation changes could be obtained (over 50% compared with that of near-infrared wavelengths). This is mainly due to the increased contrast between tissue and blood in that spectral region and the confinement of the photons to the thickness of the small intestine. Moreover, the modeling results show that the source to detector separation should be limited to roughly 6 mm while using traditional near-infrared light, with a few centimeters source to detector separation leads to poor signal-to-background ratio. Finally, a visible wavelength system is tested in an in vivo porcine study, and the possibility of monitoring intestinal perfusion changes is showed.

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© 2013 Society of Photo-Optical Instrumentation Engineers

Citation

Tony J. Akl ; Mark A. Wilson ; M. Nance Ericson and Gerard L. Coté
"Intestinal perfusion monitoring using photoplethysmography", J. Biomed. Opt. 18(8), 087005 (Aug 12, 2013). ; http://dx.doi.org/10.1117/1.JBO.18.8.087005


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