correlation between capillary oxygen saturation and small intestinal wall thickness in the equine colic patient - laser light distance measurement

Surgical Evaluation of bleeding-blocked intestines and decisions on bowel resection require a lot of experience and are subjective.
The purpose of this prospective clinical study was to study the correlation between oxygen saturation and small intestinal wall (IW)
Thickness, using two objective methods.
In 22 cold horses, the relative content of blood flow, oxygen saturation and hemoglobin was measured during surgery by laser Doppler and white light spectroscopy (
O2C, oxygen, LEA Medizintechnik)
At six measurement points (MPs)
In large intestine and small intestine
In addition, IW thickness was measured by ultrasound.
The IW thickness of 9 of 22 horses increased to more than 4mm (
Freeman 2002, Shana et al 2002, Le Joan and Combe 2014)
At the measurement point 1 (MP1)(
Stranded section)
Four horses were thickened in the intestinal wall at 3 points of measurement (MP3)(poststenotic)
There is one at the measurement point 2 (MP2).
The oxygen saturation of MP1, MP3 and MP2 of the six horses is 0 (prestenotic)in one.
Oxygen saturation and small IW thickness are independent of each other at MP1 and mp2.
In MP3, the two parameters are negatively correlated.
To sum up, it is impossible to draw a conclusion about oxygen saturation according to the IW thickness.
Introduction ischemia is a pathological decrease in perfusion that often occurs in small intestinal strangulation obstruction.
According to the literature (
Mel and Smith 2005)
The survival rate of such patients was 68.
9%, so lower than simple obstacles (90. 5%).
Different studies have shown that 85% of all small intestinal ischemia diseases are caused by strangulation (
Freeman et al 2000)
And the survival rate of this blockage (75. 2%)
Lower than the proportion of similar problems in large intestine (89. 9%)(
Mel and Smith 2005).
Oxygen saturation is a major problem in the development of ischemia disease.
As the oxidation of the tissue decreases, the cells begin to perform aerobic glycolysis, which in turn leads to the inhibition of adrenaline phosphate (ATP)
Production, followed by cell death in the final stage (Blikslager 2010).
Due to the structure of its blood vessels, the tip of the mucosa fluff is highly sensitive to reducing oxygen saturation and begins to degrade (Blikslager 2010).
These changes occur before changes in intestinal bleeding are visible and therefore mislead the surgeon.
The old saying "cut it out if in doubt" is out of date because of the increased risk of adhesion, prolonged anesthesia time, postoperative intestinal obstruction, plus an increase in the cost of resection.
Methods for detecting ischemia injury include viability score (
Freeman et al 2014)
, Fluorescence, Doppler ultrasound (
Freeman et al 1988)
And pulse oximeter (
Schmotzer, etc. 1991).
It has been proved (
Reichert, etc. 2014)
This method is suitable for evaluating the microcirculation of small intestine.
Oxygen to see (O2C)
Combined with laser Doppler spectrum and white light spectrum.
Calculate blood flow from laser
The relative content of detected red blood cell movement, oxygen saturation and hemoglobin is determined by oxygen-
Dependent changes in blood color (KrugKrug 2007).
According to the literature (
Reichert, etc. 2014)
The oxygen saturation of healthy intestines is 81. 04% (±12. 62%)
In the small intestine and 83. 44% (±11. 79%)
In the large intestine.
The relative content of hemoglobin in the intestine is 68. 41 a. u. (Any unit)(±10. 91u2009a. u. )
Blood flow is 246. 1 a. u. (±73. 43u2009a. u. )
, Similar to the results of the large intestine (haemoglobin 65. 81±9. 29u2009a. u. ; blood flow 216. 27±67. 20u2009a. u. ).
It has been confirmed that the diagnosis of diseases such as twisted narrow small intestine obstruction is very specific and sensitive (
2015) Scharner and Bankert.
Thickness of the small intestinal wall (IW)between 1. 8 and 3. 75u2009mm (
Reef 1998, Epstein and other 2008, bihill and other 2010, Scharner and Bankert 2015)
Considered physiological normal.
The IW consists of four layers: serosa, the solid layer, the submucosa and the mucosal layer, which distinguish ultrasound by various echoes (Freeman 2003).
Serosa and submucosa are highly echo, and submucosa are hypoecho (see Fig 1).
Wall thickness of more than 4mm is considered pathological (
Freeman 2002, Shana et al 2002, Le Joan and Combe 2014).
Gas cavities in the mucosa are associated with highly impaired IW and poor prognosis (
Freeman et al 2014).
The formation of edema, infiltration and proliferation diseases, Xiaoyan and intestinal obstruction can lead to thickening of IW (Sanchez 2010).
The authors assume that the decrease in oxygen saturation is positively correlated with the increase in IW thickness greater than 4mm (
Freeman 2002, Shana et al 2002, Le Joan and Combe 2014)
In the narrow part of the intestinal obstruction of the small intestine.
Download the new tabDownload figureOpen powerpointFIG (
Measurement point 3 (MP3))
Prior to data collection, research designs, parameters and assumptions were defined and agreed with the Justus veterinary department's working group on biological mathematics and data processing through differentiated, single-layer materials and methods
University of Li.
The study design is reviewed by Justus's designated animal welfare and care officerLiebig-
University of Jean.
The study does not require ethical approval according to animal law.
Horseshoe iron was collected from 22 horses, which were transferred to a caesarean section due to intestinal pain.
During surgery, all horses were diagnosed with huge changes in the small intestine and intestines.
Age from 4 to 21 (mean±SD: 16. 2±5. 3 years)
And weight (BW)
Ranging from 260 to 660 (mean±SD: 486. 4±98. 8u2009kg).
The team consists of 11 warm blood horses and 11 ponies (
The maximum height is 1. 48 m);
It includes 9 mare, 12 male and one stallion.
Anesthesia top: Measurement of macro-healthy intestines
Below: The design of statistical procedures for measurement of macro damage and discoloration pitches, as well as the analysis and evaluation of data, conducted under the supervision of the department of veterinary biology and data processing working group of Justus --
University of Li.
The predetermined sample size measurement procedure 'bias (j)’.
The limit of statistical significance is p ≤ 0.
05, Alpha is 0.
05 and a beta 0. 1.
For statistical analysis, the mean deviation between the median and the median (MD)
Determined for each parameter on each MP.
The thickness of the IW is calculated on average (±SD)
Five measurements of longitudinal and lateralSegment view.
The program BMDP (a)
For statistical evaluation.
Use correlation with program module 6D/6R and regression analysis to evaluate the relationship between the quantitative features of the MP1-MP6 (a)
Determination of partial correlation coefficient (r)
And the regression line (y=m⋅x+b).
Mixed variable time because of the partial correlation coefficient of early breast cancer in the skin (BMDP6R (a)).
Logarithmic transformation of right-correlation analysis
The partial distribution of each parameter at the MP1-MP3.
Therefore, replace the value 0 with half of the minimum positive value.
Prior to data collection, research design, parameters and assumptions being defined and agreed upon, Working Group on biomathematics and data processing with Justus Veterinary Department
University of Li.
The study design is reviewed by Justus's designated animal welfare and care officerLiebig-
University of Jean.
The study does not require ethical approval according to animal law.
Horseshoe iron was collected from 22 horses, which were transferred to a caesarean section due to intestinal pain.
During surgery, all horses were diagnosed with huge changes in the small intestine and intestines.
Age from 4 to 21 (mean±SD: 16. 2±5. 3 years)
And weight (BW)
Ranging from 260 to 660 (mean±SD: 486. 4±98. 8u2009kg).
The team consists of 11 warm blood horses and 11 ponies (
The maximum height is 1. 48 m);
It includes 9 mare, 12 male and one stallion.
Anesthesia top: Measurement of macro-healthy intestines
Below: The design of statistical procedures for measurement of macro damage and discoloration pitches, as well as the analysis and evaluation of data, conducted under the supervision of the department of veterinary biology and data processing working group of Justus --
University of Li.
The predetermined sample size measurement procedure 'bias (j)’.
The limit of statistical significance is p ≤ 0.
05, Alpha is 0.
05 and a beta 0. 1.
For statistical analysis, the mean deviation between the median and the median (MD)
Determined for each parameter on each MP.
The thickness of the IW is calculated on average (±SD)
Five measurements of longitudinal and lateralSegment view.
The program BMDP (a)
For statistical evaluation.
Use correlation with program module 6D/6R and regression analysis to evaluate the relationship between the quantitative features of the MP1-MP6 (a)
Determination of partial correlation coefficient (r)
And the regression line (y=m⋅x+b).
Mixed variable time because of the partial correlation coefficient of early breast cancer in the skin (BMDP6R (a)).
Logarithmic transformation of right-correlation analysis
The partial distribution of each parameter at the MP1-MP3.
Therefore, replace the value 0 with half of the minimum positive value.
Results: all horses had severe injuries and small intestine discoloration.
The colors of the gallows section range from dark pink, red to blue or black (see Fig 3).
Expansion of intestines or thickening of walls.
The narrow front section also expanded;
The narrow part is mostly empty, and the macro is normal.
The average Wall thickness of MP1 in all horses is 3. 7u2009mm (±1. 9u2009mm SD)
Oxygen saturation is 34. 5 a. u. (±67. 5u2009a. u. MD).
Out of 9 of 22 horses, the IW thickness of MP1 is more than 4mm.
The average Wall thickness of the nine horses was 5. 7u2009mm (±1. 2u2009mm), see Fig 4.
Table 1 shows the parameters of the MP1-MP6.
At MP1, the oxygen saturation of the six horses is 0, two at MP3 and one at mp2.
More than 4mm wall thickness was found in one of MP2's horses and four of mp3's.
Six of the 22 horses were excluded from MP3 due to intestinal obstruction in the distal intestine or rectum.
Significant correlation analysis (P=