Continuous pH monitoring using a sensor for the early detection of anastomotic leaks

Abstract

Anastomotic leaks (AL) and staple line leaks are a serious post-operative complication that can develop following bariatric surgery. The delay in the onset of symptoms following a leak usually results in reactive diagnostics and treatment, leading to increased patient morbidity and mortality, and a clinical and economic burden on both the patient and the hospital. Despite support in literature for pH as a biomarker for early detection of AL, the current methods of pH detection require significant clinician involvement and resources. Presented here is a polyaniline (PANI)-based pH sensor that can be connected inline to surgical drains to continuously monitor peritoneal secretion in real time for homeostatic changes in pH. During this study, the baseline peritoneal fluid pH was measured in two pigs using the PANI sensor and verified using a benchtop pH probe. The PANI sensor was then utilized to continuously monitor the changes in the pH of peritoneal effluent, as a gastric leak was simulated. The inline sensors were able to detect the resulting local changes in drainage pH within 10 min of leak induction. The successful implementation of this sensor in clinical practice can both enable high efficiency continuous monitoring of patient status and drastically decrease the time required to detect AL, thus potentially decreasing the clinical and economic burden incurred by gastric leaks.

Early Detection and Monitoring of Anastomotic Leaks via Naked Eye‐Readable, Non‐Electronic Macromolecular Network Sensors

“…Previous studies showed that the pH value of the drain fluids only shows minimal fluctuations between pH 7 and 8. [52] The amylase, lipase and trypsin activity within this range is not affected by pH (Figure S10, Supporting Information). With regard to temperature-dependence, the trypsin and amylase sensors show a modest temperature dependence and slower reaction at room temperature compared to body temperature (e.g., 1.5 h instead of 1 h for levels of 100 U mL −1 amylase, and 3.5 h vs 1 h for 100 μg mL −1 trypsin), while the lipase sensor only shows clinically feasible reaction times at body temperature.…”