Risk factors for nonocclusive mesenteric ischemia after cardiac surgery
Keywords:
non-occlusive mesenteric ischemia, cardiac surgery, risk factor.Abstract
Introduction: Non-occlusive mesenteric ischemia can occur after elective cardiac surgery and it is critical to identify those at high risk for developing this complication.Objective: To identify risk factors associated with non-occlusive mesenteric ischemia after cardiac surgery.
Development: The risk factors identified were age > 70 years, use of vasopressors, intra-aortic balloon pump implantation, use of cardiovascular bypass, blood transfusions, loss of sinus rhythm, left ventricular ejection fraction < 35% and aortic clamp time > 100 minutes.
Conclusions: The risk factors found in the review were age > 70 years, use of vasopressors, intra-aortic balloon pump implantation, use of cardiovascular bypass, blood transfusions, loss of sinus rhythm, left ventricular ejection fraction (LVEF) < 35 % and aortic clamp time > 100 min.
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References
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23. Dai Y, Chen X, Song X, Chen X, Ma W, Lin J, et al. Immunotherapy of Endothelin-1 Receptor Type A for Pulmonary Arterial Hypertension. J Am Coll Cardiol. 2019; 73(20):2567-80. DOI: 10.1016/j.jacc.2019.02.067
24. Li P, Schmidt IM, Sabbisetti V, Tio MC, Opotowsky AR, Waikar SS. Plasma Endothelin-1 and Risk of Death and Hospitalization in Patients Undergoing Maintenance Hemodialysis. Clin J Am Soc Nephrol CJASN. 2020; 15(6):784-93. DOI: 10.2215/CJN.11130919
25. Hartopo AB, Sukmasari I, Puspitawati I, Setianto BY. Serum Endothelin-1 Correlates with Myocardial Injury and Independently Predicts Adverse Cardiac Events in Non-ST-Elevation Acute Myocardial Infarction. Int J Vasc Med. 2020; 2020: 9260812. DOI: 10.1155/2020/9260812
26. Leary PJ, Jenny NS, Bluemke DA, Kawut SM, Kronmal RA, Lima JA, et al. Endothelin-1, cardiac morphology, and heart failure: the MESA angiogenesis study. J Heart Lung Transplant Off Publ Int Soc Heart Transplant. 2020; 39(1):45-52. DOI: 10.1016/j.healun.2019.07.007
27. Groesdonk HV, Raffel M, Speer T, Bomberg H, Schmied W, Klingele M, et al. Elevated endothelin-1 level is a risk factor for nonocclusive mesenteric ischemia. J Thorac Cardiovasc Surg. 2015; 149(5): 1436-1442.e2. DOI: 10.1016/j.jtcvs.2014.12.019
2. Lawson RM. Mesenteric Ischemia. Crit Care Nurs Clin North Am. 2018; 30(1):29-39. DOI: 10.1016/j.cnc.2017.10.003
3. Sato H, Nakamura M, Uzuka T, Kondo M. Detection of patients at high risk for nonocclusive mesenteric ischemia after cardiovascular surgery. J Cardiothorac Surg. 2018;13(1):115. DOI: 10.1186/s13019-018-0807-5
4. Lim JY, Kim JB, Jung SH, Choo SJ, Chung CH, Lee JW. Risk factor analysis for nonocclusive mesenteric ischemia following cardiac surgery: A case-control study. Medicine (Baltimore). 2017;96(37):e8029. DOI: 10.1097/MD.0000000000008029
5. Groesdonk HV, Klingele M, Schlempp S, Bomberg H, Schmied W, Minko P, et al. Risk factors for nonocclusive mesenteric ischemia after elective cardiac surgery. J Thorac Cardiovasc Surg. 2013; 145(6):1603-10. DOI: 10.1016/j.jtcvs.2012.11.022
6. Yap KH, Chua KC, Lim SL, Sin YK. Is it possible to predict the risk of ischaemic bowel after cardiac surgery? Interact Cardiovasc Thorac Surg. 2014;19(3):494-8. DOI: 10.1093/icvts/ivu145
7. Kammerer S, Schuelke C, Berkemeyer S, Velasco A, Heindel W, Koehler M, et al. The role of multislice computed tomography (MSCT) angiography in the diagnosis and therapy of non-occlusive mesenteric ischemia (NOMI): Could MSCT replace DSA in diagnosis? PloS One. 2018; 13(3): e0193698. DOI: 10.1371/journal.pone.0193698
8. Mastoraki A, Mastoraki S, Tziava E, Touloumi S, Krinos N, Danias N, et al. Mesenteric ischemia: Pathogenesis and challenging diagnostic and therapeutic modalities. World J Gastrointest Pathophysiol. 2016; 7(1):125-30. DOI: 10.4291/wjgp.v7.i1.125
9. Andersson B, Andersson R, Brandt J, Höglund P, Algotsson L, Nilsson J. Gastrointestinal complications after cardiac surgery - improved risk stratification using a new scoring model. Interact Cardiovasc Thorac Surg. 2010; 10(3):366-70. DOI: 10.1510/icvts.2009.219113
10. Corcos O, Castier Y, Sibert A, Gaujoux S, Ronot M, Joly F, et al. Effects of a multimodal management strategy for acute mesenteric ischemia on survival and intestinal failure. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2013; 11(2):158-165.e2. DOI: 10.1016/j.cgh.2012.10.027
11. Becker LS, Stahl K, Meine TC, von Falck C, Meyer BC, Dewald CLA, et al. Non-occlusive mesenteric ischemia (NOMI): evaluation of 2D-perfusion angiography (2D-PA) for early treatment response assessment. Abdom Radiol NY. 2020; 45(10):3342-51. DOI: 10.1007/s00261-020-02457-y
12. Bourcier S, Oudjit A, Goudard G, Charpentier J, Leblanc S, Coriat R, et al. Diagnosis of non-occlusive acute mesenteric ischemia in the intensive care unit. Ann Intensive Care. 2016; 6(1):112. DOI: 10.1186/s13613-016-0213-x
13. D'Ancona G, Kische S, Ince H. Perioperative endothelin-1 levels: Searching for the hidden fingerprint of nonocclusive mesenteric ischemia. J Thorac Cardiovasc Surg. 2015; 149(5):1443-4. DOI: 10.1016/j.jtcvs.2015.02.034
14. Vasile I, Meşină C, Paşalega M, Calotă F, Vâlcea ID. Nonocclusive acute mesenteric ischemia. Chir Buchar Rom 1990. 2008 [acceso: 21/12/2021]; 103(3):337-43. Disponible en: https://pubmed.ncbi.nlm.nih.gov/18717285/
15. Argenziano M, Chen JM, Choudhri AF, Cullinane S, Garfein E, Weinberg AD, et al. Management of vasodilatory shock after cardiac surgery: identification of predisposing factors and use of a novel pressor agent. J Thorac Cardiovasc Surg. 1998; 116(6):973-80. DOI: 10.1016/S0022-5223(98)70049-2
16. Goleanu V, Alecu L, Lazar O. Acute mesenteric ischemia after heart surgery. Chir Buchar Rom 1990. 2014 [acceso: 21/12/2021]; 109(3):402-6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/24956349/
17. Abboud B, Daher R, Boujaoude J. Acute mesenteric ischemia after cardio-pulmonary bypass surgery. World J Gastroenterol. 2008; 14(35):5361-70. DOI: 10.3748/wjg.14.5361
18. Fitzgerald T, Kim D, Karakozis S, Alam H, Provido H, Kirkpatrick J. Visceral ischemia after cardiopulmonary bypass. Am Surg. 2000 [acceso: 21/12/2021]; 66(7):623-6. Disponible en: https://pubmed.ncbi.nlm.nih.gov/10917470/
19. Trompeter M, Brazda T, Remy CT, Vestring T, Reimer P. Non-occlusive mesenteric ischemia: etiology, diagnosis, and interventional therapy. Eur Radiol. 2002; 12(5):1179-87. DOI: 10.1007/s00330-001-1220-2
20. Jenkins HN, Rivera-Gonzalez O, Gibert Y, Speed JS. Endothelin-1 in the pathophysiology of obesity and insulin resistance. Obes Rev Off J Int Assoc Study Obes. 2020; 21(12): e13086. DOI: 10.1111/obr.13086
21. Nankervis CA, Schauer GM, Miller CE. Endothelin-mediated vasoconstriction in postischemic newborn intestine. Am J Physiol Gastrointest Liver Physiol. 2000; 279(4): G683-691. DOI: 10.1152/ajpgi.2000.279.4.G683
22. Bomberg H, Bierbach B, Flache S, Wagner I, Gläser L, Groesdonk HV, et al. Endothelin and vasopressin influence splanchnic blood flow distribution during and after cardiopulmonary bypass. J Thorac Cardiovasc Surg. 2013; 145(2):539-47. DOI: 10.1016/j.jtcvs.2012.03.014
23. Dai Y, Chen X, Song X, Chen X, Ma W, Lin J, et al. Immunotherapy of Endothelin-1 Receptor Type A for Pulmonary Arterial Hypertension. J Am Coll Cardiol. 2019; 73(20):2567-80. DOI: 10.1016/j.jacc.2019.02.067
24. Li P, Schmidt IM, Sabbisetti V, Tio MC, Opotowsky AR, Waikar SS. Plasma Endothelin-1 and Risk of Death and Hospitalization in Patients Undergoing Maintenance Hemodialysis. Clin J Am Soc Nephrol CJASN. 2020; 15(6):784-93. DOI: 10.2215/CJN.11130919
25. Hartopo AB, Sukmasari I, Puspitawati I, Setianto BY. Serum Endothelin-1 Correlates with Myocardial Injury and Independently Predicts Adverse Cardiac Events in Non-ST-Elevation Acute Myocardial Infarction. Int J Vasc Med. 2020; 2020: 9260812. DOI: 10.1155/2020/9260812
26. Leary PJ, Jenny NS, Bluemke DA, Kawut SM, Kronmal RA, Lima JA, et al. Endothelin-1, cardiac morphology, and heart failure: the MESA angiogenesis study. J Heart Lung Transplant Off Publ Int Soc Heart Transplant. 2020; 39(1):45-52. DOI: 10.1016/j.healun.2019.07.007
27. Groesdonk HV, Raffel M, Speer T, Bomberg H, Schmied W, Klingele M, et al. Elevated endothelin-1 level is a risk factor for nonocclusive mesenteric ischemia. J Thorac Cardiovasc Surg. 2015; 149(5): 1436-1442.e2. DOI: 10.1016/j.jtcvs.2014.12.019
Published
2022-07-22
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Caballero-Alvarado J, Rodríguez García A, Rodríguez Guzmán M, Namay Polo A, Lozano Peralta K. Risk factors for nonocclusive mesenteric ischemia after cardiac surgery. Rev Cubana Med Milit [Internet]. 2022 Jul. 22 [cited 2025 Apr. 1];51(3):e02201800. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/1800
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