Intestinal Ischemia and Reperfusion: Consequences and Mechanisms

Granger, D. Neil; Seifert, Hilary; Senchenkova, Elena Y.

doi:10.1007/978-3-642-37078-6_240

Cited by 4 publications

(3 citation statements)

References 76 publications

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“…Increased viscosity of the blood, reduction in deformability of RBCs, increased blood vessel shear stress, changes in vasodilation, and circulatory remodeling are common in cyanotic CHD [ 49 ], and likely contribute to the pathogenesis of cardiac NEC. Thus, the neonatal intestine lacks the critical collateral networks and pressure-flow autoregulation of an adult, and when combined with a higher tissue basal metabolic rate, is far more susceptible to ischemia [ 50 ].…”

Section: Pathogenesis Of Intestinal Injury In Congenital Heart Diseasementioning

confidence: 99%

Clinical Characteristics and Potential Pathogenesis of Cardiac Necrotizing Enterocolitis in Neonates with Congenital Heart Disease: A Narrative Review

Burge

Gunasekaran

Makoni

et al. 2022

JCM

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Neonates with congenital heart disease (CHD) are at an increased risk of developing necrotizing enterocolitis (NEC), an acute inflammatory intestinal injury most commonly associated with preterm infants. The rarity of this complex disease, termed cardiac NEC, has resulted in a dearth of information on its pathophysiology. However, a higher incidence in term infants, effects on more distal regions of the intestine, and potentially a differential immune response may distinguish cardiac NEC as a distinct condition from the more common preterm, classical NEC. In this review, risk factors, differentiated from those of classical NEC, are discussed according to their potential contribution to the disease process, and a general pathogenesis is postulated for cardiac NEC. Additionally, biomarkers specific to cardiac NEC, clinical outcomes, and strategies for achieving enteral feeds are discussed. Working towards an understanding of the mechanisms underlying cardiac NEC may aid in future diagnosis of the condition and provide potential therapeutic targets.

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Section: Pathogenesis Of Intestinal Injury In Congenital Heart Diseasementioning

confidence: 99%

Clinical Characteristics and Potential Pathogenesis of Cardiac Necrotizing Enterocolitis in Neonates with Congenital Heart Disease: A Narrative Review

Burge

Gunasekaran

Makoni

et al. 2022

JCM

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“…Acute SMA occlusion in contrast to low flow states and left-sided colonic ischemia, causes a more significant reduction in blood flow with rapid progression to intestinal infarction and therefore requires immediate treatment. 13…”

Section: Pathophysiology and Diagnosis Of Acute Mesenteric Ischemiamentioning

confidence: 99%

Acute Mesenteric Ischemia

Lendzion

Frahm-Jensen

Keck

2022

Clin Colon Rectal Surg

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The surgical treatment of occlusive acute mesenteric ischemia (AMI) without revascularization is associated with an 80% overall mortality. Early diagnosis is crucial, and revascularization may reduce overall mortality in AMI by up to 50%. A diagnosis of AMI requires a high index of clinical suspicion and the collaborative effort of emergency department physicians, general and vascular surgeons, and radiologists. This article provides an overview of the etiology, physiology, evaluation, and management of acute mesenteric ischemia.

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“…The decrease in oxygenation can be caused either by a decrease in arterial blood with rich oxygenation or by possible pooling of venous blood. The signi cantly low oxygenation after reperfusion in the severe AMI group may due to vasospasm, thrombosis, and congestion in damaged intestinal tissue 21 .…”

Section: Sequential Real-time Evaluation Of Oxygenationmentioning

confidence: 99%

Predicting Intestinal Viability After Acute Mesenteric Ischemia by Photoacoustic Imaging: An Experimental Study in Rats

Sugiura

Okumura

Matsumoto

et al. 2021

Preprint

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Our purpose was to assess the ability of photoacoustic imaging (PAI) to objectively predict ischemic intestinal pathological damage during surgery for acute mesenteric ischemia (AMI). PAI uses laser light to detect relative amounts of oxygenated and deoxygenated hemoglobin in intestinal tissue. In 18 rats, AMI was induced by clamping the mesenteric and marginal vessels of the ileum for 0 minutes in the sham group (n = 6), 30 minutes in the mild group (n = 6), and 180 minutes in the severe group (n = 6). After 60 minutes of reperfusion, the damage of the intestine was evaluated pathologically. Oxygenation of the intestine was monitored throughout the procedure in real time by the PAI system and compared between the mild and severe groups. All rats showed irreversible (i.e. transmucosal or transmural infarction) damage in the severe group. After reperfusion, the oxygenation in the mild group recovered immediately and was significantly higher than in the severe group at 1, 5, 10, 30, and 60 minutes (P = .007, 014, 016, 008, and 003, respectively). Oxygenation showed a significant strong negative correlation with the pathological severity. In conclusion, PAI could objectively predict irreversible ischemic damage immediately after reperfusion, which potentially prevents inadequate surgery.

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Intestinal Ischemia and Reperfusion: Consequences and Mechanisms

Cited by 4 publications

References 76 publications

Clinical Characteristics and Potential Pathogenesis of Cardiac Necrotizing Enterocolitis in Neonates with Congenital Heart Disease: A Narrative Review

Clinical Characteristics and Potential Pathogenesis of Cardiac Necrotizing Enterocolitis in Neonates with Congenital Heart Disease: A Narrative Review

Acute Mesenteric Ischemia

Predicting Intestinal Viability After Acute Mesenteric Ischemia by Photoacoustic Imaging: An Experimental Study in Rats

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