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Splanchnic ischemia

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https://www.readbyqxmd.com/read/29851668/my-love-affair-with-the-venous-system
#1
Simon Gelman
Aortic cross-clamping (AoX) and unclamping are associated with severe hemodynamic disturbances in virtually all organs and systems. The main hemodynamic changes induced by AoX result from an increase in impedance to aortic flow, an increase in systemic vascular resistance and afterload, blood volume redistribution caused by collapse and constriction of venous vasculature distal to the aortic clamp, and a subsequent increase in preload. Preload may not increase if the aorta is clamped distal to the celiac artery; in that case, blood volume from distal venous vasculature may be redistributed to the splanchnic vasculature without associated increases in preload...
May 31, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29622358/arterial-reconstructions-for-pediatric-splanchnic-artery-occlusive-disease
#2
Dawn M Coleman, Jonathan L Eliason, James C Stanley
OBJECTIVE: Pediatric splanchnic arterial occlusive disease is uncommon and a rare cause of clinically relevant intestinal ischemia. This study was undertaken to better define the clinical manifestations and appropriate treatment of celiac artery (CA) and superior mesenteric artery (SMA) occlusive disease in children. METHODS: Clinical courses of 30 consecutive children undergoing operations for splanchnic arterial occlusive disease at the University of Michigan from 1992 to 2017 were retrospectively analyzed...
April 2, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29574759/humanizing-the-mouse-immune-system-to-study-splanchnic-organ-inflammation
#3
Brianyell McDaniel Mims, Matthew B Grisham
It is well known that alterations in splanchnic organ perfusion and/or immune regulation may produce inflammatory tissue injury similar to that observed in several human disorders such as ischaemia and reperfusion injury, food allergies, diabetes, inflammatory bowel disease and graft-versus-host disease. Mouse models have been tremendously important in defining the roles of the circulation, leukocyte trafficking, inflammatory mediator generation, immune regulation and the intestinal microbiota in the pathogenesis of acute and chronic inflammation...
March 24, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29508410/selective-cerebro-myocardial-perfusion-in-complex-neonatal-aortic-arch-pathology-midterm-results
#4
Stiljan Hoxha, Riccardo Giuseppe Abbasciano, Camilla Sandrini, Lucia Rossetti, Tiziano Menon, Luca Barozzi, Daniele Linardi, Alessio Rungatscher, Giuseppe Faggian, Giovanni Battista Luciani
Aortic arch repair in newborns and infants has traditionally been accomplished using a period of deep hypothermic circulatory arrest. To reduce neurologic and cardiac dysfunction related to circulatory arrest and myocardial ischemia during complex aortic arch surgery, an alternative and novel strategy for cerebro-myocardial protection was recently developed, where regional low-flow perfusion is combined with controlled and independent coronary perfusion. The aim of the present retrospective study was to assess short-term and mid-term results of selective and independent cerebro-myocardial perfusion in neonatal aortic arch surgery...
April 2018: Artificial Organs
https://www.readbyqxmd.com/read/29472709/splanchnic-nirs-monitoring-in-neonatal-care-rationale-current-applications-and-future-perspectives
#5
REVIEW
Silvia Martini, Luigi Corvaglia
Near infrared spectroscopy (NIRS) provides a non-invasive, continuous monitoring of regional tissue oxygenation. NIRS assessment of neonatal splanchnic oxygenation (SrSO2 ) has gained increasing interest over the last decade, as local hypoxia and ischemia underlie the most feared gut complications in neonates. Current literature provides encouraging evidence in support of SrSO2 reliability in detecting mesenteric hemodynamic changes related to various physiological and pathological conditions in-term and preterm infants...
February 22, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29456403/severe-abdominal-complaints-after-technical-successful-endovascular-treatment-of-chronic-splanchnic-ischemia
#6
Claire A J I Leenarts, Mark J F Haagmans, Lee H Bouwman, Cornelis J J M Sikkink
Reperfusion syndrome (RS) after revascularization of an arterial occlusion of the lower leg is a well-known complication. RS after splanchnic revascularization, however, is an infrequent and less-known phenomenon. We present a patient with persisting abdominal complaints after revascularization of the celiac trunk and superior mesenteric artery suggesting reocclusion. Although computed tomography angiography showed patent splanchnic arteries, an impressive hyperperfusion state of liver and spleen was visualized...
January 2018: Journal of Natural Science, Biology, and Medicine
https://www.readbyqxmd.com/read/29372026/transient-paraplegia-after-neurolytic-splanchnic-block-in-a-patient-with-metastatic-colon-carcinoma
#7
Gonca Oguz, Gulcin Senel, Nesteren Kocak
We present a patient with metastatic colon carcinoma who developed paraplegia following a neurolytic splanchnic block. A 41-year old man with metastatic adenocarcinoma of the colon received a splanchnic neurolytic block using alcohol because of severe abdominal pain. Bilateral motor weakness and a sensorial deficit in both legs developed after the procedure. Diffusion magnetic resonance imaging revealed spinal cord ischemia between T8 and L1. The motor and sensorial deficits were almost completely resolved at the end of the third month...
January 2018: Korean Journal of Pain
https://www.readbyqxmd.com/read/28983255/the-regulatory-effects-of-lateral-hypothalamus-area-gabab-receptor-on-gastric-ischemia-reperfusion-injury-in-rats
#8
Lin Gao, Huiru Zhao, Tao Zhu, Yeliu Liu, Li Hu, Zhenguo Liu, Hai Huang, Fuxue Chen, Zhenxu Deng, Dechang Chu, Dongshu Du
HIGHLIGHTS The aim of the research was to determine the functional effects and molecular mechanisms of GABAB receptor on ischemia reperfusion-induced gastric injury in rats.The lateral hypothalamus area GABAB receptor attenuated the ischemia reperfusion-induced gastric injury by up-regulating the production of GABA, GABABR, and down-regulating P-GABABR in the brain.This work would provide a new therapeutic strategy for acute gastric injury. Gastric ischemia-reperfusion (GI-R) injury progression is largely associated with excessive activation of the greater splanchnic nerve (GSN)...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28887256/remote-ischemic-preconditioning-decreases-the-magnitude-of-hepatic-ischemia-reperfusion-injury-on-a-swine-model-of-supraceliac-aortic-cross-clamping
#9
Georgios Martikos, Alkistis Kapelouzou, Michael Peroulis, Anna Paspala, Dimitris Athanasiadis, Anastasios Machairas, Theodoros Liakakos, Konstantinos Moulakakis, Spyros Vasdekis, Andreas M Lazaris
BACKGROUND: Temporary hepatic ischemia is inevitable during open aortic surgery when supraceliac clamping is necessary, as in thoracoabdominal or pararenal aneurysms. Remote ischemic preconditioning (RIPC) has been described as a potential protective means against ischemia-reperfusion injury (IRI) in various tissues including the liver. The aim of this experimental study was to detect the effect of RIPC on liver IRI in a model of supraceliac aortic cross-clamping. METHODS: An animal study was performed...
April 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28602971/new-developments-in-hepatorenal-syndrome
#10
Ayse L Mindikoglu, Stephen C Pappas
Hepatorenal syndrome (HRS) continues to be one of the major complications of decompensated cirrhosis, leading to death in the absence of liver transplantation. Challenges in precisely evaluating renal function in the patient with cirrhosis remain because of the limitations of serum creatinine (Cr) alone in estimating glomerular filtration rate (GFR); current GFR estimating models appear to underestimate renal dysfunction. Newer models incorporating renal biomarkers, such as the Cr-Cystatin C GFR Equation for Cirrhosis appear to estimate measured GFR more accurately...
June 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28323233/iloprost-use-in-patients-with-persistent-intestinal-ischemia-unsuitable-for-revascularization
#11
Alexandre Nuzzo, Damien Soudan, Lore Billiauws, Julie Bataille, Léon Maggiori, Maxime Ronot, Jeanick Stocco, Yoram Bouhnik, Yves Castier, Olivier Corcos
BACKGROUND: Persistent or chronic intestinal ischemic injury (i3) can lead to severe malnutrition and acute mesenteric ischemia. Although recommended, revascularization of splanchnic arteries is sometimes unrealizable. METHODS: We report a case series of iloprost use in consecutive stable patients with persistent i3 unsuitable for revascularization followed in a tertiary care center. The feasibility of revascularization was discussed and ruled out by a multidisciplinary team, and informed consent was obtained prior to consideration of a vasoactive therapy...
July 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28115983/an-investigation-of-bedside-laparoscopy-in-the-icu-for-cases-of-non-occlusive-mesenteric-ischemia
#12
G Cocorullo, A Mirabella, N Falco, T Fontana, R Tutino, L Licari, G Salamone, G Scerrino, G Gulotta
BACKGROUND: Acute mesenteric ischemia is a rare affection with high related mortality. NOMI presents the most important diagnostic problems and is related with the higher risk of white laparotomy. This study wants to give a contribution for the validation of laparoscopic approach in case of NOMI. METHODS: Thirty-two consecutive patients were admitted in last 10 years in ICU of Paolo Giaccone University Hospital of Palermo for AMI. Diagnosis was obtained by multislice CT and selective angiography was done if clinical conditions were permissive...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/27706895/benefits-of-temporary-portocaval-shunt-during-orthotopic-liver-transplantation-with-vena-cava-preservation-a-propensity-score-analysis
#13
COMPARATIVE STUDY
Michel Rayar, Giovanni B Levi Sandri, Caterina Cusumano, Clara Locher, Pauline Houssel-Debry, Christophe Camus, Nicolas Lombard, Veronique Desfourneaux, Mohamed Lakehal, Bernard Meunier, Laurent Sulpice, Karim 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 (ECDs). Temporary portocaval shunt (TPCS) could prevent these complications. Between 2002 and 2013, all OLTs 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)...
February 2017: Liver Transplantation
https://www.readbyqxmd.com/read/27604672/a-case-of-gastro-duodenal-artery-aneurism-treatment-and-complications
#14
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
#15
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...
January 2017: Der Internist
https://www.readbyqxmd.com/read/27280940/low-volume-resuscitation-using-polyethylene-glycol-20k-in-a-preclinical-porcine-model-of-hemorrhagic-shock
#16
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 an LVR solution for hemorrhagic shock in a preclinical model...
December 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
#17
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...
March 2017: Acta Radiologica
https://www.readbyqxmd.com/read/27136469/ischemia-modified-albumin-does-it-change-during-pneumoperitoneum-in-robotic-prostatectomies
#18
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
#19
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
#20
COMPARATIVE STUDY
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
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