Laser speckle contrast imaging for quantitative assessment of facial flushing during mesenteric traction syndrome in upper gastrointestinal surgery

Linea Landgrebe Ring; Rune B Strandby; Amalie Henriksen; Rikard Ambrus; Henrik Sørensen; Jens Peter Gøtze; Lars Bo Svendsen; Michael Patrick Achiam

doi:10.1007/s10877-018-0226-0

Laser speckle contrast imaging for quantitative assessment of facial flushing during mesenteric traction syndrome in upper gastrointestinal surgery

Linea Landgrebe Ring, Rune B Strandby^*, Amalie Henriksen, Rikard Ambrus, Henrik Sørensen, Jens Peter Gøtze, Lars Bo Svendsen, Michael Patrick Achiam

^*Corresponding author for this work

5 Citations (Scopus)

Abstract

The mesenteric traction syndrome (MTS) is associated with prostacyclin (PGI₂) facilitated systemic vasodilatation during surgery and is identified by facial flushing. We hypothesized that severe facial flushing would be related to the highest concentrations of plasma PGI₂ and accordingly to the highest levels of skin blood flow measured by laser speckle contrast imaging (LSCI). Patients scheduled for major upper abdominal surgery were consecutively included. Within the first hour of the procedure, facial flushing was scored according to a standardized scale, and skin blood flow (LSPU) was continuously measured on the forehead and the cheeks by LSCI. Arterial blood samples for 6-keto-PGF_1α (stable metabolite of PGI₂) and hemodynamic variables were obtained at defined time points. Overall, 66 patients were included. After 15 min of surgery, patients with severe flushing demonstrated the highest plasma 6-keto-PGF_1α concentration and the most significant decrease in systemic vascular resistance. Accordingly, the skin blood flow on the forehead (238 [201–372] to 562 LSPU [433–729]) and the cheeks (341 [239–355] to 624 LSPU [468–917]) increased and were significantly higher than for patients with moderate or no flushing (both, P = 0.04). A cut-off value for skin blood flow could be defined for both the cheeks and the forehead for patients with severe flushing vs. no flushing (425/456 LSPU, sensitivity 75/76% and specificity 80/85%). MTS is linked to an increase in facial skin blood flow during upper gastrointestinal surgery. By applying LSCI, it is possible to quantitatively register facial blood flow, and thereby provide an objective tool for intraoperative verification of MTS.

Original language	English
Journal	Journal of Clinical Monitoring and Computing
Volume	33
Issue number	5
Pages (from-to)	903-910
Number of pages	8
ISSN	1387-1307
DOIs	https://doi.org/10.1007/s10877-018-0226-0
Publication status	Published - 2019
Externally published	Yes

Keywords

Facial flushing; prostacyclin
Laser speckle contrast imaging
Mesenteric traction syndrome
Skin blood flow

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10.1007/s10877-018-0226-0

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Ring, L. L., Strandby, R. B., Henriksen, A., Ambrus, R., Sørensen, H., Gøtze, J. P., Svendsen, L. B., & Achiam, M. P. (2019). Laser speckle contrast imaging for quantitative assessment of facial flushing during mesenteric traction syndrome in upper gastrointestinal surgery. Journal of Clinical Monitoring and Computing, 33(5), 903-910. https://doi.org/10.1007/s10877-018-0226-0

Laser speckle contrast imaging for quantitative assessment of facial flushing during mesenteric traction syndrome in upper gastrointestinal surgery. / Ring, Linea Landgrebe; Strandby, Rune B; Henriksen, Amalie et al.

In: Journal of Clinical Monitoring and Computing, Vol. 33, No. 5, 2019, p. 903-910.

Research output: Contribution to journal › Journal article › Research › peer-review

Ring, LL, Strandby, RB, Henriksen, A, Ambrus, R, Sørensen, H, Gøtze, JP , Svendsen, LB & Achiam, MP 2019, 'Laser speckle contrast imaging for quantitative assessment of facial flushing during mesenteric traction syndrome in upper gastrointestinal surgery', Journal of Clinical Monitoring and Computing, vol. 33, no. 5, pp. 903-910. https://doi.org/10.1007/s10877-018-0226-0

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abstract = "The mesenteric traction syndrome (MTS) is associated with prostacyclin (PGI2) facilitated systemic vasodilatation during surgery and is identified by facial flushing. We hypothesized that severe facial flushing would be related to the highest concentrations of plasma PGI2 and accordingly to the highest levels of skin blood flow measured by laser speckle contrast imaging (LSCI). Patients scheduled for major upper abdominal surgery were consecutively included. Within the first hour of the procedure, facial flushing was scored according to a standardized scale, and skin blood flow (LSPU) was continuously measured on the forehead and the cheeks by LSCI. Arterial blood samples for 6-keto-PGF1α (stable metabolite of PGI2) and hemodynamic variables were obtained at defined time points. Overall, 66 patients were included. After 15 min of surgery, patients with severe flushing demonstrated the highest plasma 6-keto-PGF1α concentration and the most significant decrease in systemic vascular resistance. Accordingly, the skin blood flow on the forehead (238 [201–372] to 562 LSPU [433–729]) and the cheeks (341 [239–355] to 624 LSPU [468–917]) increased and were significantly higher than for patients with moderate or no flushing (both, P = 0.04). A cut-off value for skin blood flow could be defined for both the cheeks and the forehead for patients with severe flushing vs. no flushing (425/456 LSPU, sensitivity 75/76% and specificity 80/85%). MTS is linked to an increase in facial skin blood flow during upper gastrointestinal surgery. By applying LSCI, it is possible to quantitatively register facial blood flow, and thereby provide an objective tool for intraoperative verification of MTS.",

keywords = "Facial flushing; prostacyclin, Laser speckle contrast imaging, Mesenteric traction syndrome, Skin blood flow",

author = "Ring, {Linea Landgrebe} and Strandby, {Rune B} and Amalie Henriksen and Rikard Ambrus and Henrik S{\o}rensen and G{\o}tze, {Jens Peter} and Svendsen, {Lars Bo} and Achiam, {Michael Patrick}",

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T1 - Laser speckle contrast imaging for quantitative assessment of facial flushing during mesenteric traction syndrome in upper gastrointestinal surgery

AU - Ring, Linea Landgrebe

AU - Strandby, Rune B

AU - Henriksen, Amalie

AU - Ambrus, Rikard

AU - Sørensen, Henrik

AU - Gøtze, Jens Peter

AU - Svendsen, Lars Bo

AU - Achiam, Michael Patrick

N1 - (Ekstern)

PY - 2019

Y1 - 2019

N2 - The mesenteric traction syndrome (MTS) is associated with prostacyclin (PGI2) facilitated systemic vasodilatation during surgery and is identified by facial flushing. We hypothesized that severe facial flushing would be related to the highest concentrations of plasma PGI2 and accordingly to the highest levels of skin blood flow measured by laser speckle contrast imaging (LSCI). Patients scheduled for major upper abdominal surgery were consecutively included. Within the first hour of the procedure, facial flushing was scored according to a standardized scale, and skin blood flow (LSPU) was continuously measured on the forehead and the cheeks by LSCI. Arterial blood samples for 6-keto-PGF1α (stable metabolite of PGI2) and hemodynamic variables were obtained at defined time points. Overall, 66 patients were included. After 15 min of surgery, patients with severe flushing demonstrated the highest plasma 6-keto-PGF1α concentration and the most significant decrease in systemic vascular resistance. Accordingly, the skin blood flow on the forehead (238 [201–372] to 562 LSPU [433–729]) and the cheeks (341 [239–355] to 624 LSPU [468–917]) increased and were significantly higher than for patients with moderate or no flushing (both, P = 0.04). A cut-off value for skin blood flow could be defined for both the cheeks and the forehead for patients with severe flushing vs. no flushing (425/456 LSPU, sensitivity 75/76% and specificity 80/85%). MTS is linked to an increase in facial skin blood flow during upper gastrointestinal surgery. By applying LSCI, it is possible to quantitatively register facial blood flow, and thereby provide an objective tool for intraoperative verification of MTS.

AB - The mesenteric traction syndrome (MTS) is associated with prostacyclin (PGI2) facilitated systemic vasodilatation during surgery and is identified by facial flushing. We hypothesized that severe facial flushing would be related to the highest concentrations of plasma PGI2 and accordingly to the highest levels of skin blood flow measured by laser speckle contrast imaging (LSCI). Patients scheduled for major upper abdominal surgery were consecutively included. Within the first hour of the procedure, facial flushing was scored according to a standardized scale, and skin blood flow (LSPU) was continuously measured on the forehead and the cheeks by LSCI. Arterial blood samples for 6-keto-PGF1α (stable metabolite of PGI2) and hemodynamic variables were obtained at defined time points. Overall, 66 patients were included. After 15 min of surgery, patients with severe flushing demonstrated the highest plasma 6-keto-PGF1α concentration and the most significant decrease in systemic vascular resistance. Accordingly, the skin blood flow on the forehead (238 [201–372] to 562 LSPU [433–729]) and the cheeks (341 [239–355] to 624 LSPU [468–917]) increased and were significantly higher than for patients with moderate or no flushing (both, P = 0.04). A cut-off value for skin blood flow could be defined for both the cheeks and the forehead for patients with severe flushing vs. no flushing (425/456 LSPU, sensitivity 75/76% and specificity 80/85%). MTS is linked to an increase in facial skin blood flow during upper gastrointestinal surgery. By applying LSCI, it is possible to quantitatively register facial blood flow, and thereby provide an objective tool for intraoperative verification of MTS.

KW - Facial flushing; prostacyclin

KW - Laser speckle contrast imaging

KW - Mesenteric traction syndrome

KW - Skin blood flow

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U2 - 10.1007/s10877-018-0226-0

DO - 10.1007/s10877-018-0226-0

M3 - Journal article

C2 - 30460600

AN - SCOPUS:85056806010

SN - 1387-1307

VL - 33

SP - 903

EP - 910

JO - Journal of Clinical Monitoring and Computing

JF - Journal of Clinical Monitoring and Computing

IS - 5

ER -

Laser speckle contrast imaging for quantitative assessment of facial flushing during mesenteric traction syndrome in upper gastrointestinal surgery

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Keywords

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