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Splanchnic ischemia

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https://www.readbyqxmd.com/read/27706895/benefits-of-temporary-portocaval-shunt-during-orthotopic-liver-transplantation-with-vena-cava-preservation-a-propensity-score-analysis
#1
M Rayar, G B Levi Sandri, C Cusumano, C Locher, P Houssel-Debry, C Camus, N Lombard, V Desfourneaux, M Lakehal, B Meunier, L Sulpice, K Boudjema
During orthotopic liver transplantation (OLT), clamping of the portal vein induces splanchnic venous congestion and accumulation of noxious compounds. These adverse effects could increase ischemia-reperfusion injury and subsequently the risk of graft dysfunction, especially for grafts harvested from extended criteria donors (ECD). Temporary portocaval shunt (TPCS) could prevent these complications. Between 2002 and 2013, all OLT performed in our center were retrospectively analyzed and a propensity score matching analysis was used to compare the effect of TPCS in 686 patients (343 in each group)...
October 5, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27604672/a-case-of-gastro-duodenal-artery-aneurism-treatment-and-complications
#2
Jean-Loup Gassend, Maria Dimitrief, Hon Lai Chan, Daniel Roulet, Lysiane Trachsel, Francesco Doenz, Floryn Cherbanyk
We present the case of a 75-year-old patient with asymptomatic gastro-duodenal artery aneurism (GAA) that was coiled through the left femoral artery. The gastro-duodenal artery (GDA) was then embolized. Following the intervention, the patient'™s left foot became cold. A sub-acute ischemia caused by a stenotic effect in the left external iliac artery and by lower limb embolic phenomena caused by the introductor, was diagnosed. A thromboembolectomy of the popliteal, anterior and posterior tibial and peroneal arteries was performed with a Fogarty catheter with good results...
July 2016: Chirurgia
https://www.readbyqxmd.com/read/27573529/-recent-thrombosis-of-splanchnic-veins-two-case-reports-of-catheter-assisted-local-thrombolysis-and-thrombus-aspiration
#3
M Praktiknjo, C Meyer, C P Strassburg, J Trebicka
Recent non-cirrhotic and non-malignant splanchnic vein thrombosis is now defined as extrahepatic portal vein thrombosis with or without involvement of the mesenteric vein according to the Baveno VI consensus from 2015. An early diagnosis is often challenging due to unspecific symptoms with abdominal pain or diarrhea but extremely important because of the potential acute and chronic complications, such as mesenteric ischemia and portal hypertension; therefore, rapid treatment is crucial. We present two cases of severe splanchnic vein thrombosis, which were treated with catheter-directed local thrombolysis and thrombus aspiration...
August 29, 2016: Der Internist
https://www.readbyqxmd.com/read/27280940/low-volume-resuscitation-using-polyethylene-glycol-20k-in-a-pre-clinical-porcine-model-of-hemorrhagic-shock
#4
Valerie Plant, Ashley Limkemann, Loren Liebrecht, Charles Blocher, Paula Ferrada, Michel Aboutanos, Martin J Mangino
INTRODUCTION: Polyethylene glycol-20k (PEG-20k) is highly effective for low volume resuscitation (LVR) by increasing tolerance to the low volume state. In our rodent shock model, PEG-20k increased survival and expanded the "golden hour" 16-fold compared to saline. The molecular mechanism is largely attributed to normalizations in cell and tissue fluid shifts after low flow ischemia resulting in efficient microvascular exchange. The objective of this study was to evaluate PEG-20k as a low volume resuscitation solution for hemorrhagic shock in a pre-clinical model...
June 8, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27178034/outcome-of-primary-percutaneous-stent-revascularization-in-patients-with-atherosclerotic-acute-mesenteric-ischemia
#5
Robert Forbrig, Philipp Renner, Piotr Kasprzak, Marc-H Dahlke, René Müller-Wille, Christian Stroszczynski, Peter Heiss
BACKGROUND: Patients with acute mesenteric ischemia (AMI) often exhibit severe co-morbidities and significant surgical risks, leading to high perioperative morbidity. PURPOSE: To investigate the feasibility of primary percutaneous stent-revascularization (PPSR) in atherosclerotic AMI and its impact on patients' outcome. MATERIAL AND METHODS: Retrospective analysis of 19 consecutive patients (7 women, 12 men; median age, 69 years) with AMI caused by atherosclerotic, non-embolic stenoses/occlusions of the splanchnic arteries and PPSR...
May 13, 2016: Acta Radiologica
https://www.readbyqxmd.com/read/27136469/ischemia-modified-albumin-does-it-change-during-pneumoperitoneum-in-robotic-prostatectomies
#6
Serpil Ustalar Ozgen, Bora Ozveren, Meltem Kilercik, Ugur Aksu, Binnaz Ay, Ilter Tufek, Ali Riza Kural, Levent N Turkeri, Fevzi Toraman
BACKGROUND: The unique positioning of the patient at steep Trendelenburg with prolonged and increased intra-abdominal pressure (IAP) during robotic radical prostatectomy may increase the risk of splanchnic ischemia. We aimed to investigate the acute effects of IAP and steep Trendelenburg position on the level of ischemia modified albumin (IMA) and to test if serum IMA levels might be used as a surrogate marker for possible covert ischemia during robotic radical prostatectomies. PATIENTS AND METHODS: Fifty ASA I-II patients scheduled for elective robotic radical prostatectomy were included in this investigation...
January 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27113513/urgent-multivisceral-transplantation-for-widespread-splanchnic-ischemia
#7
Lisa M Sharkey, Neil K Russell, Charlotte S Rutter, Stephen J Middleton, J Andrew Bradley, Neville V Jamieson, Andrew J Butler
BACKGROUND: Multivisceral transplantation (transplantation of the stomach, intestine, liver, and pancreas) is usually undertaken as a semi-elective procedure after thorough assessment in patients who have intestinal failure with cirrhosis, cirrhosis with portomesenteric venous thrombosis, or tumors such as desmoids involving the liver and mesentery. STUDY DESIGN: Data were collected prospectively from the time of referral and held in a central database. We used it to report the first cases of urgent multivisceral transplantation (MVT) in patients with widespread splanchnic ischemia (occlusion of the celiac axis and superior mesenteric artery) resulting in small bowel infarction and hepatic failure...
May 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/27026260/does-hyperbaric-oxygen-therapy-reduce-the-effects-of-ischemia-on-colonic-anastomosis-in-laparoscopic-colon-resection
#8
Seyfi Emir, Sibel Ozkan Gurdal, Selim Sozen, Ilhan Bali, Ebru Yesildag, Atilla Celik, Savas Guzel, Onder Sahin, Hakan Ay, Birol Topcu
BACKGROUND: An increase in intra-abdominal pressure causes a decrease in the splanchnic blood flow and the intramucosal pH of the bowel, as well as increasing the risk of ischemia in the colon. The aim of the present study is to evaluate the effect of hyperbaric oxygen therapy (HBOT) on the ischemia caused by laparoscopy in colonic anastomosis in an experimental model of laparoscopic colonic surgery. MATERIALS AND METHODS: We divided 30 male Wistar albino rats into three groups: Group A was the control (open colon anastomosis); Group B received LCA (laparoscopic colon anastomosis); while Group C received both LCA and HBOT...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/26899618/fatal-non-occlusive-mesenteric-ischemia-and-the-use-of-propranolol-in-paediatric-burns
#9
R Martinez, A Rogers, A Numanoglu, H Rode
Abdominal complications without abdominal injury are infrequently seen in children with major burns. They are divided into those that occur early during the emergency phase of treatment and those that occur late in the course of treatment. One of the most serious late onset complications is non-occlusive mesenteric ischaemia associated with the use of vasoactive drugs. We report on 2 children who late in the course of their burn injury developed ischaemic necrosis of their entire intestine. Both were on propranolol, the administration of which was continued with even during the periods of septic shock which preceded their demise...
June 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/26713734/increased-hepato-splanchnic-vasoconstriction-in-diabetics-during-regular-hemodialysis
#10
Werner Ribitsch, Daniel Schneditz, Casper F M Franssen, Gernot Schilcher, Vanessa Stadlbauer, Jörg H Horina, Alexander R Rosenkranz
BACKGROUND AND OBJECTIVES: Ultrafiltration (UF) of excess fluid activates numerous compensatory mechanisms during hemodialysis (HD). The increase of both total peripheral and splanchnic vascular resistance is considered essential in maintaining hemodynamic stability. The aim of this study was to evaluate the extent of UF-induced changes in hepato-splanchnic blood flow and resistance in a group of maintenance HD patients during regular dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Hepato-splanchnic flow resistance index (RI) and hepato-splanchnic perfusion index (QI) were measured in 12 chronic HD patients using a modified, non-invasive Indocyaningreen (ICG) dilution method...
2015: PloS One
https://www.readbyqxmd.com/read/26680087/effect-and-mechanism-of-portal-blood-stasis-removal-on-intestinal-endotoxemia-and-hepatic-ischemia-reperfusion-injury
#11
Y Wang, Z-S Liu, S-L Zhang, Q-X Diao, Y-J Ge
OBJECTIVE: We used a rabbit model of hepatic ischemia reperfusion in situ to observe the change of portal venous endotoxin level before reperfusion, and the effect of portal blood stasis removal on intestinal endotoxemia and hepatic ischemia reperfusion injury. The purpose was to find an ideal method for portal blood stasis removal and provide the experimental proof for clinical application of hepatectomy. METHODS AND MATERIALS: To investigate the effect of portal blood stasis removal on intestinal endotoxemia and hepatic ischemia reperfusion injury, a rabbit hepatic ischemia reperfusion injury model was established and treated with removal of portal blood stasis before the portal blood circulation was resumed...
November 2015: Transplantation Proceedings
https://www.readbyqxmd.com/read/26632492/complement-c5a-inhibition-improves-late-hemodynamic-and-inflammatory-changes-in-a-rat-model-of-nonocclusive-mesenteric-ischemia
#12
COMPARATIVE STUDY
Dániel Érces, Miklós Nógrády, Gabriella Varga, Szilárd Szűcs, András Tamás Mészáros, Tamás Fischer-Szatmári, Chun Cao, Noriko Okada, Hidechika Okada, Mihály Boros, József Kaszaki
BACKGROUND: Nonocclusive mesenteric ischemia (NOMI) can evolve in a variety of low-flow states. Although the mechanisms leading to NOMI-related intestinal necrosis are largely unknown, circumstantial evidence suggests that excessive vasoconstriction and complement activation both play important roles in this process. Because targeting of the circulatory malfunction of the splanchnic area could be of therapeutic relevance, we set out to investigate the long-term effects of treatment with a complement C5a antagonist in a rat model of partial aortic occlusion (PAO)-induced transient mesenteric hypoperfusion...
March 2016: Surgery
https://www.readbyqxmd.com/read/26600801/imaging-diagnosis-of-splanchnic-venous-thrombosis
#13
REVIEW
S Rajesh, Amar Mukund, Ankur Arora
Splanchnic vein thrombosis (SVT) is a broad term that includes Budd-Chiari syndrome and occlusion of veins that constitute the portal venous system. Due to the common risk factors involved in the pathogenesis of these clinically distinct disorders, concurrent involvement of two different regions is quite common. In acute and subacute SVT, the symptoms may overlap with a variety of other abdominal emergencies while in chronic SVT, the extent of portal hypertension and its attendant complications determine the clinical course...
2015: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/26446769/sex-difference-in-the-influence-of-central-blood-volume-mobilization-on-the-exercise-pressor-response
#14
Sophie Lalande, Carly C Barron, J Kevin Shoemaker
PURPOSE: To determine the sex difference in the impact of central venous pressure (CVP) on the pressor response induced by ischemic handgrip exercise. METHODS: Twelve young healthy individuals (six males, 25 ± 3 years) performed ischemic handgrip exercise during mild levels of lower body negative pressure (LBNP, -5 mmHg) and during a 10° head-down tilt (HDT) to lower and increase CVP, respectively. The protocol consisted of 3 min of baseline ischemia, followed by 2 min of isometric handgrip exercise at 35 % of maximal voluntary contraction force, and 2 min of post-exercise circulatory occlusion...
December 2015: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/26375087/inf-ir-7-bergamot-juice-extract-exerts-a-notable-anti-inflammatory-and-anti-oxidant-effect-in-a-murine-model-of-intestinal-ischemia-reperfusion
#15
M Campolo, D Impellizzeri, G Bruschetta, G Casili, E Esposito, S Cuzzocrea
INTRODUCTION: Bergamot Juice extract (BJe) has raised much interest in recent years; it exerts many properties such us anti-inflammatory activity through both anti-oxidant effects and modulation of pivotal pro-inflammatory genes. Certain flavonoids have been shown to possess antiulcer activity and were able to prevent gastric mucosal lesions produced by various ulcer-producing methods, therefore, the aim of this study was to investigate the effects of BJe in a murine model of Intestinal Ischemia/Reperfusion (I/R)...
October 2015: Shock
https://www.readbyqxmd.com/read/26346675/protective-effect-of-heme-oxygenase-1-on-wistar-rats-with-heart-failure-through-the-inhibition-of-inflammation-and-amelioration-of-intestinal-microcirculation
#16
Li Zhang, Zhuo-Kun Gan, Li-Na Han, Hao Wang, Jie Bai, Guo-Juan Tan, Xiao-Xia Li, Ya-Ping Xu, Yu Zhou, Mei-Liang Gong, Mo-Si Lin, Xiao-Yang Han
BACKGROUND: Myocardial infarction (MI) has likely contributed to the increased prevalence of heart failure (HF). As a result of reduced cardiac function, splanchnic blood flow decreases, causing ischemia in villi and damage to the intestinal barrier. The induction of heme oxygenase-1 (HO-1) could prevent, or lessen the effects of stress and inflammation. Thus, the effect and mechanism thereof of HO-1 on the intestines of rats with HF was investigated. METHODS: Male Wistar rats with heart failure through ligation of the left coronary artery were identified with an left ventricular ejection fraction of < 45% through echocardiography and then divided into various experimental groups based on the type of peritoneal injection they received [MI: saline; MI + Cobalt protoporphyrin (CoPP): CoPP solution; and MI + Tin mesoporphyrin IX dichloride (SnMP): SnMP solution]...
July 2015: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/26291907/chronic-mesenteric-ischemia-a-rare-cause-of-chronic-abdominal-pain
#17
Maximilien Barret, Chloé Martineau, Gabriel Rahmi, Olivier Pellerin, Marc Sapoval, Jean-Marc Alsac, Jean-Noël Fabiani, Georgia Malamut, Elia Samaha, Christophe Cellier
BACKGROUND: Chronic mesenteric ischemia is a rare disease with nonspecific clinical symptoms, such as chronic postprandial abdominal pain and weight loss. Diagnostic modalities and revascularization techniques have evolved during the past 20 years. The significance of stenosis in a single splanchnic vessel remains unclear. Our aims were to assess the outcomes of 2 revascularization techniques and report on the diagnostic modalities of splanchnic vessel stenoses. METHODS: The demographic data, medical history, technical characteristics, and outcomes of the revascularization procedures were recorded for all of the patients admitted for endovascular revascularization or open surgical revascularization of the splanchnic vessels as treatment for chronic mesenteric ischemia in our tertiary referral center since 2000...
December 2015: American Journal of Medicine
https://www.readbyqxmd.com/read/26226020/effect-of-feeding-and-suction-on-gastric-impedance-spectroscopy-measurements
#18
Nohra E Beltran, Gustavo Sánchez-Miranda, Emilio Sacristan
A specific device and system has been developed and tested for clinical monitoring of gastric mucosal reactance in the critically ill as an early warning of splanchnic hypoperfusion associated with shock and sepsis. This device has been proven effective in clinical trials and is expected to become commercially available next year. The system uses a combination nasogastric tube and impedance spectroscopy probe as a single catheter. Because this device has a double function, the question is: Does enteral feeding or suction affect the gastric reactance measurements? This study was designed to evaluate the effect of feeding and suction on the measurement of gastric impedance spectroscopy in healthy volunteers...
July 2015: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/26177478/off-pump-debranching-and-thoracic-endovascular-aortic-repair-for-aortic-arch-pathology
#19
Tamer Ghazy, Ahmed Mashhour, Torsten Schmidt, Adrian Mahlmann, Ahmed Ouda, Hans-Joachim Florek, Klaus Matschke, Utz Kappert
OBJECTIVE: This study aimed to simplify an until-now complex procedure for the treatment of proximal aortic arch pathology (zones 0 and 1), where a deep hypothermic circulatory arrest even with selective cerebral perfusion is still a high-risk procedure with accompanying splanchnic and spinal cord ischemia. METHODS: From June 2012 until March 2013, 106 patients underwent aortic surgery in our institution, of whom, 20 patients underwent aortic arch surgery. Of the 20 patients, 7 with multiple comorbidities and a high operative risk and no other indication for a cardiopulmonary bypass were selected to undergo an off-pump aortic arch debranching and thoracic endovascular aortic repair: 4 patients had chronic dissections, and 3 patients had arch aneurysms...
May 2015: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/26108029/effect-of-protective-solutions-and-hydroxyethyl-starch-in-the-attenuation-of-the-injuries-of-ischemia-and-reperfusion-of-splanchnic-organs
#20
COMPARATIVE STUDY
Marcelo Eduardo Ribeiro, Julio Sequeira, Luzia Aparecida Trinca, Winston Bonetti Yoshida
PURPOSE: Vogt´s antioxidant solution (red blood cells, Ringer's solution, sodium bicarbonate, mannitol, allopurinol and 50% glucose) or its modification including hydroxyethyl starch (HES) were tested for the prevention of splanchnic artery occlusion shock. METHODS: Seventy rats were distributed in treatment (3), control (1), and sham (3) groups. Ischemia and reperfusion were induced by celiac, superior mesenteric and inferior mesenteric arteries occlusion for 40 min, followed by 60 min reperfusion or sham procedures...
June 2015: Acta Cirúrgica Brasileira
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