Detection of patients at high risk for non-occlusive mesenteric ischemia in hemodialysis

Non-occlusive mesenteric ischaemia: The prevalent cause of gastrointestinal infarction in patients with severe burn injuries

“…The reduction of mesenteric blood flow can be caused by hypotension, a reduction in cardiac output, a vasospasm of the mesenteric arteries, or sepsis. Recent studies demonstrated the frequent occurrence of nonocclusive mesenteric ischaemia after cardiac and vascular surgery [8][9][10][11] and also in chronic hemodialysis patients [12]. According to these studies, risk factors for the occurrence of a NOMI in cardiovascular patients are increased serum lactate levels > 5 mmmol/L, the application of an intra-aortal balloon pump, and the need for hemodialysis [13].…”

“…According to these studies, risk factors for the occurrence of a NOMI in cardiovascular patients are increased serum lactate levels > 5 mmmol/L, the application of an intra-aortal balloon pump, and the need for hemodialysis [13]. Additionally, for dialysis patients, the duration of their dialysis and comorbid diabetes mellitus are additional risk factors [12,14]. The goal of our research was to investigate the aetiology of gastrointestinal infarction in severe-burn intensive care patients and to evaluate potential predictive factors for this event and its outcome.…”

The Relationship between Intradialytic Hypotension and Hospitalized Mesenteric Ischemia

“…Although IDH appears to be a potent risk factor for triggering mesenteric ischemia, it is not the only factor in patients with ESKD, as it has also been described in patients on peritoneal dialysis (25). Patients with ESKD share many of the predisposing factors for other causes of abnormal splanchnic vasculature, including hypertension, diabetes, atherosclerosis, dyslipidemia, advanced age, and heart failure (7,8,19). However, the large sample size allowed us to adjust for these other risk factors, and the association of IDH (identified using one of the four nadir-based definitions) with mesenteric ischemia persisted even after taking into account any differences in these characteristics between cases and matched controls.…”

“…In turn, IDH is associated with numerous adverse outcomes including inadequate dialysis, thrombosis of vascular access, cardiovascular events, and death (10)(11)(12)(13)(14)(15)(16). Previous case reports (6,17) and single-center studies (3,8,18,19) have suggested an association between IDH and mesenteric ischemia. However, a comprehensive evaluation in patients on hemodialysis in the United States has yet to be conducted.…”

Elevated Fasting Plasma Glucose before Liver Transplantation is Associated with Lower Post-Transplant Survival

“…In addition, thrombotic angiopathy in a patient in a diabetic state has been associated with the oxidative modification of von Willebrand factor [23]. Studies have found HAT [24], PVT [25], NOMI [26], and TMA [27] are related to DM and high plasma glucose. Thus, patients with high FPG prior to LT should be monitored closely for vascular complications, including HAT, PVT, NOMI, TMA, and stroke after LT.…”