Qualitative and quantitative fluorescein fluorescence in determining intestinal viability

Mitchel S. Carter, Gary A. Fantinl, Robert J. Sammartano, Sumi Mttsudo, David G. Silverman, Scott J. Boley

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

Clinical evaluation and qualitative (visual) and quantitative (fluorometric) fluorescence for predicting intestinal viability were compared in an animal model of temporary arterial occlusion with early revascularization. Quantitative fluorescence was determined with a perfusion fluorometer after an intravenous bolus of fluorescein. Qualitative fluorescence was determined by examination under a Wood's lamp in a darkened room. The effectiveness of each diagnostic technique in determining nonviability was expressed in terms of sensitivity, specificity, and accuracy. All three methods had 100 percent specificity; only bowel deemed nonviable proved to be so. Quantitative fluorescence also had a 100 percent sensitivity, but clinical evaluation and qualitative fluorescence had only a 33 and 11 percent sensitivity, respectively (some segments of bowel that were ultimately nonviable were not correctly predicted to be so). The inaccuracy of qualitative fluorescence was due to the fact that ischemic intestine with a hyperfluorescent pattern often progressed to necrosis. Fluorometric quantitation identified those hyperfluorescent segments that were viable. This study suggests that visual fluorescence is not reliable in assessing intestinal viability after early revascularization after arterial occlusion, but quantitative fluorometric fluorescence is reliable in almost all instances.

Original languageEnglish (US)
Pages (from-to)117-123
Number of pages7
JournalThe American Journal of Surgery
Volume147
Issue number1
DOIs
Publication statusPublished - Jan 1984
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

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