scholarly journals The Level of Certain Interleukins and Tissue Factor in Conditions of Intestinal Ischemia and Reperfusion in Rats

2020 ◽  
Vol 10 (4) ◽  
pp. 416-420
Author(s):  
Zoya Artamonova ◽  
Evgeny Namokonov ◽  
Marina Darenskaya ◽  
Natalya Semenova ◽  
Lyubov Kolesnikova ◽  
...  
Keyword(s):  
Tissue Factor ◽  
Mesenteric Ischemia ◽  
Intestinal Ischemia ◽  
Acute Mesenteric Ischemia ◽  
Male Rats ◽  
Blood Levels ◽  
Time Intervals ◽  
Rat Blood ◽  
Laboratory Markers ◽  
Systemic Inflammatory Reaction

Background: The aim of this study was to estimate the blood levels of interleukins (ILs) and tissue factor (TF) in rat blood when modeling acute mesenteric ischemia (AMI) in various stages and during reperfusion. Methods and Results: The study was performed on white non-linear male rats, weighing 200±25g. AMI was simulated by ligating the cranial mesenteric artery at the mesentery root. Then, at certain time intervals, a relaparotomy was performed, blood was collected, and the animals were subjected to reperfusion at different time intervals. During the experiment, the animals were divided into 3 groups depending on the time of ischemia (3 hours [n=10], 6 hours [n=10], and 8 hours [n=10]) followed by reperfusion after the indicated time of ischemia. The level of ILs (IL-6, IL-8, and IL-10) and TF in rat blood serum was determined by EIA. We found that AMI in rats is accompanied by pronounced changes in the immune system and the development of a systemic inflammatory reaction syndrome, which is aggravated by reperfusion. At the same time, the restoration of blood flow after 3-hour ischemia was characterized by an increase in the concentration of IL-6, IL-8, and IL-10; after 6-hour ischemia – by an increase in the IL-6, IL-8 content and TF, and stabilization of the IL-10 concentration. Reperfusion after 8-hour ischemia was accompanied by an increase in the IL-6 concentration, a decrease in the levels of IL-8, IL-10, and TF, which can lead to the progression of necrotic changes in the intestine. Conclusion: The detected changes can serve as laboratory markers that characterize the course and stage of acute mesenteric ischemia.

scholarly journals Acute Mesenteric Ischemia in COVID-19 Patients

2021 ◽  
Vol 11 (1) ◽  
pp. 200
Author(s):  
Dragos Serban ◽  
Laura Carina Tribus ◽  
Geta Vancea ◽  
Anca Pantea Stoian ◽  
Ana Maria Dascalu ◽  
...  
Keyword(s):  
Small Bowel ◽  
Mesenteric Ischemia ◽  
Intestinal Ischemia ◽  
Clinical Laboratory ◽  
Fluid Management ◽  
Acute Mesenteric Ischemia ◽  
Bowel Ischemia ◽  
Reactive Protein ◽  
Contrast Enhanced Ct ◽  
The Moment

Acute mesenteric ischemia is a rare but extremely severe complication of SARS-CoV-2 infection. The present review aims to document the clinical, laboratory, and imaging findings, management, and outcomes of acute intestinal ischemia in COVID-19 patients. A comprehensive search was performed on PubMed and Web of Science with the terms “COVID-19” and “bowel ischemia” OR “intestinal ischemia” OR “mesenteric ischemia” OR “mesenteric thrombosis”. After duplication removal, a total of 36 articles were included, reporting data on a total of 89 patients, 63 being hospitalized at the moment of onset. Elevated D-dimers, leukocytosis, and C reactive protein (CRP) were present in most reported cases, and a contrast-enhanced CT exam confirms the vascular thromboembolism and offers important information about the bowel viability. There are distinct features of bowel ischemia in non-hospitalized vs. hospitalized COVID-19 patients, suggesting different pathological pathways. In ICU patients, the most frequently affected was the large bowel alone (56%) or in association with the small bowel (24%), with microvascular thrombosis. Surgery was necessary in 95.4% of cases. In the non-hospitalized group, the small bowel was involved in 80%, with splanchnic veins or arteries thromboembolism, and a favorable response to conservative anticoagulant therapy was reported in 38.4%. Mortality was 54.4% in the hospitalized group and 21.7% in the non-hospitalized group (p < 0.0001). Age over 60 years (p = 0.043) and the need for surgery (p = 0.019) were associated with the worst outcome. Understanding the mechanisms involved and risk factors may help adjust the thromboprophylaxis and fluid management in COVID-19 patients.

scholarly journals Comparative study of the influence of colloid-hyperosmolar and protein-salt solutions on anti-inflammatory and detoxification processes in rats with burn shock

2020 ◽  
pp. 60-61
Author(s):  
A.O. Ocheretnyuk ◽  
B.O. Kondratsky ◽  
O.V. Palamarchuk ◽  
V.A. Vashchuk
Keyword(s):  
White Male ◽  
Male Rats ◽  
Infusion Therapy ◽  
Blood Levels ◽  
Burn Shock ◽  
Systemic Inflammatory Reaction ◽  
Anti Inflammatory ◽  
Blood Leukocyte ◽  
Systemic Stress ◽  
Destructive Processes

Objective. Experimentally justify the use of colloidal-hyperosmolar solution based on hydroxyethyl starch HAES-LX-5 % and protein-salt solution based on albumin Lactoprotein with sorbitol (LPS) in burn shock (BS). Materials and methods. The experiments were performed on an experimental model of OS in white male rats. HAES-LX-5 %, LPS solution and control 0.9 % NaCl solution at a dose of 10 ml/kg/day for 7 days were used for infusion therapy. The blood leukocyte intoxication index (LII), medium weight molecules (MWM), C-reactive protein (CRP) were studied. Results and discussion. In the conditions of experimental BS with the introduction of 0.9 % NaCl, the LII on the 7th day significantly increased by 5.37 times (p<0.01) compared with intact animals (0.887±0.108 and 0.165±0.098, respectively). This indicates the development of destructive processes and intoxication of rats in BS. When HAES-LX-5 % and LPS were administered, LII increased only 2.33 times (p<0.01) and 2.41 times (p <0.05) and was significantly lower compared to 0.9 % NaCl. In animals from the group of control pathology there was an increase in blood levels of MWM, on the 1st day by 75.6 %, on the 3rd day – by 159.5 %, and on the 7th day – by 128.0 %, respectively, compared with intact animals. A systemic inflammatory reaction was also formed, which was manifested by an increase in the level of CRP. Pharmacological correction of BS with HAES-LX-5 % and LPS solutions equally inhibited the development of endotoxicosis from the 3rd to the 7th day, which was accompanied by significant (p<0.05) decrease in the level of MWM by 36.2 % and 42.5 %, respectively, after administration of HAES-LX-5 % and by 32.9 % and 38.8 % after administration of LPS relative to control pathology. The use of solutions of HAES-LX-5 % and LPS inhibited the development of inflammation from the 3rd to the 7th day, which was accompanied by a significant (p<0.05) decrease in the level of CRP by 30.7 % and 35.0 % for HAES-LX-5 %, by 29.4 % and 32.9 % for LPS compared to control. Conclusions. It has been experimentally shown in the model of BS that solutions HAES-LX-5 % and LPS show anti-inflammatory activity and reduce the level of endogenous intoxication, inhibiting the development of systemic stress.

AN EMERGENT MANAGEMENT OF ACUTE SUPERIOR MESENTERIC ARTERY EMBOLISM WITH ILEAL GANGRENE

2021 ◽  
pp. 3-4
Author(s):  
Nishant Agarwal ◽  
Abhishek Kaushal ◽  
Shrey Aren ◽  
Srikanth Muraleedhar ◽  
Sudhir Kumar Panigrahi
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Intestinal Ischemia ◽  
Hospital Admissions ◽  
Bowel Resection ◽  
Acute Mesenteric Ischemia ◽  
Artery Embolism ◽  
Visceral Arteries ◽  
Bowel Gangrene

Acute mesenteric ischemia (AMI) occuring due to sudden, partial or complete interruption of blood ow in main visceral arteries of the abdomen eventually resulting in intestinal ischemia and/or bowel gangrene is a surgical emergency. It represents 0.1% of hospital admissions and 2% of the revascularization operations for atheromatous lesions. 50% of AMI is caused by embolic phenomenon, 25% by thrombotic episode and rest 25% by both. The most common vessel involved in AMI is superior mesenteric artery. Acute mesenteric embolic ischemia (AMEI) arises typically from a cardiac emboli in patients with atrial brillation or following MI. Patients usually presents with central abdominal pain, out of proportion to the physical ndings initially, later becoming diffuse associated with bloody diarrhoea during the episode. An early diagnosis, an aggressive resuscitation, intravascular or surgical restoration of blood ow and subsequent bowel resection based on bowel viability helps reduce morbidity and mortality.

scholarly journals Acute mesenteric ischemia: Do biomarkers contribute to diagnosis?

2014 ◽  
Vol 155 (41) ◽  
pp. 1615-1623 ◽  
Author(s):  
Olivér Rosero ◽  
László Harsányi ◽  
Attila Szijártó
Keyword(s):  
Early Diagnosis ◽  
Mesenteric Ischemia ◽  
Intestinal Ischemia ◽  
Intensive Therapy ◽  
Acute Mesenteric Ischemia ◽  
Serological Markers ◽  
Laboratory Findings ◽  
Emergency Condition ◽  
Clinical Presentations

Acute mesenteric ischemia is an emergency condition that requires immediate therapy. Despite advances in the fields of surgery and intensive therapy, the mortality of this condition remains high. This is due to the broad variability of clinical presentations and non-specific laboratory findings, which delay the diagnosis allowing the ischemia to progress and further worsening the patients’ chances of survival. Thus, there is a significant need for reliable and enhanced serological markers of intestinal ischemia. The authors review the traditionally used and novel experimental serological markers for early diagnosis of mesenteric ischemia. Orv. Hetil., 2014, 155(41), 1615–1623.

Nonocclusive Mesenteric Ischemia: A Lethal Complication in Peritoneal Dialysis Patients

2007 ◽  
Vol 27 (2) ◽  
pp. 136-141 ◽  
Author(s):  
Fotios Archodovassilis ◽  
Emmanuel E. Lagoudiannakis ◽  
Dimitrios Konstantinos Tsekouras ◽  
Konstantinos Vlachos ◽  
Konstantinos Albanopoulos ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Mesenteric Ischemia ◽  
Intestinal Ischemia ◽  
Correct Diagnosis ◽  
Acute Mesenteric Ischemia ◽  
Dialysis Patients ◽  
Nonocclusive Mesenteric Ischemia ◽  
Stage Renal Disease ◽  
End Stage ◽  
High Index Of Suspicion

Nonocclusive mesenteric ischemia (NOMI) is a relatively uncommon disorder, seen primarily in elderly patients with cardiac disease, and is characterized by progressive intestinal ischemia leading to infarction, sepsis, and death. It is suspected of being the underlying cause in at least 20% – 30% of acute mesenteric ischemia patients. End-stage renal disease patients are among the highest risk populations for developing this lethal complication; however, NOMI is not unique to hemodialysis and can occur in peritoneal dialysis patients as well. Unfortunately, the presentation of NOMI is very similar to that of peritonitis. The key to correct diagnosis is a high index of suspicion in predisposed patients. The high mortality rate is a clear reflection of failure to recognize the syndrome at an earlier, treatable stage. We present our case experience and an extensive review of the literature regarding this dreadful complication that may be reversible if considered early as a possible etiology and the appropriate diagnostic maneuvers undertaken.

Acute mesenteric ischemia with necrosis of entire small intestine

2019 ◽  
Vol 98 (4) ◽  
pp. 174-177
Keyword(s):  
Small Intestine ◽  
Mesenteric Ischemia ◽  
Severe Disease ◽  
Acute Mesenteric Ischemia ◽  
Diagnostic Methods ◽  
Entire Small Intestine ◽  
Common Etiology

The case study describes a case of a patient with acute mesenteric ischemia with necrosis of entire small intestine. In following text there is an overview of the incidence of acute mesenteric ischemia, its most common etiology, diagnostic methods and treatment of this severe disease.

Use of indocianine green fluorescence in acute mesenteric ischemia

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Jaime Bonnín-Pascual
Keyword(s):  
Indocyanine Green ◽  
Terminal Ileum ◽  
Mesenteric Ischemia ◽  
Intestinal Anastomosis ◽  
Acute Mesenteric Ischemia ◽  
Left Colon ◽  
Infrared Light ◽  
High Morbidity ◽  
Green Fluorescence ◽  
Clinical Cases

Introduction: Acute mesenteric ischemia has a high morbidity and mortality and constitutes an intraoperative challenge in the management of ischemic areas. In this context, we analyze the use of indocyanine green fluorescence to assess intestinal vascularization through 3 clinical cases. Case presentation: we present 3 clinical cases operated for acute mesenteric ischemia. Evaluation of intestinal viability is performed under infrared light after intravenous infusion of 25 mg of indocyanine green. Case 1 is a 42-year-old male with multiple antecedents of severe vascular disease, presenting with a massive acute mesenteric ischemia involving multiple intestinal segments. Fluorescence allows two adjusted bowel resections with double intestinal anastomosis. Case 2 is a 74-year-old woman with a history of non-anticoagulated atrial fibrillation who is decided to perform an urgent surgery when an esophageal, gastric and portal system pneumatosis is observed, as indirect signs of ischemia, in urgent CT. During the surgical act there is an ischemia of the terminal ileum and right colon without clear signs of involvement at the esophageal-gastric level. The assessment after administration of ICG discriminates the clear ischemic involvement from terminal ileum to ascending colon and patched in the transverse and left colon, without esophageal or gastric involvement. Case 3 is a 49-year-old woman with aortoiliac and visceral Takayasu disease and revascularization surgery of the celiac trunk. Given the increase in abdominal pain, a new CT scan demonstrates colonic pneumatosis. Urgent laparotomy shows necrosis at the level of the left colon and hypoperfusion of the cecum. The administration of ICG finds a lack of uptake of the entire colon. A subtotal colectomy with ileostomy and mucous fistula is performed. Introduction: Acute mesenteric ischemia has a high morbidity and mortality and constitutes an intraoperative challenge in the management of ischemic areas. In this context, we analyze the use of indocyanine green fluorescence to assess intestinal vascularization through 3 clinical cases. Case presentation: we present 3 clinical cases operated for acute mesenteric ischemia. Evaluation of intestinal viability is performed under infrared light after intravenous infusion of 25 mg of indocyanine green. Case 1 is a 42-year-old male with multiple antecedents of severe vascular disease, presenting with a massive acute mesenteric ischemia involving multiple intestinal segments. Fluorescence allows two adjusted bowel resections with double intestinal anastomosis. Case 2 is a 74-year-old woman with a history of non-anticoagulated atrial fibrillation who is decided to perform an urgent surgery when an esophageal, gastric and portal system pneumatosis is observed, as indirect signs of ischemia, in urgent CT. During the surgical act there is an ischemia of the terminal ileum and right colon without clear signs of involvement at the esophageal-gastric level. The assessment after administration of ICG discriminates the clear ischemic involvement from terminal ileum to ascending colon and patched in the transverse and left colon, without esophageal or gastric involvement. Case 3 is a 49-year-old woman with aortoiliac and visceral Takayasu disease and revascularization surgery of the celiac trunk. Given the increase in abdominal pain, a new CT scan demonstrates colonic pneumatosis. Urgent laparotomy shows necrosis at the level of the left colon and hypoperfusion of the cecum. The administration of ICG finds a lack of uptake of the entire colon. A subtotal colectomy with ileostomy and mucous fistula is performed. Conclusions: The fluorescence with ICG provides a better visualization of the intestinal vascularization in the AMI, and allows to determine the limits of the affected tissue to perform adjusted resections.

D-dimer as a marker for early diagnosis of acute mesenteric ischemia

2006 ◽  
Vol 117 (4) ◽  
pp. 463-467 ◽  
Author(s):  
Hüseyin Altinyollar ◽  
Mustafa Boyabatli ◽  
Uğur Berberoğlu
Keyword(s):  
Early Diagnosis ◽  
Mesenteric Ischemia ◽  
Acute Mesenteric Ischemia ◽  
D Dimer
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