Nonocclusive mesenteric ischemia in patients with methamphetamine use

Anderson, Jamie E.; Brown, Ian E.; Olson, Kristin; Iverson, Katherine M.; Cocanour, Christine S.; Galante, Joseph M.

doi:10.1097/ta.0000000000001855

Cited by 26 publications

(16 citation statements)

References 27 publications

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“…2 Multiple case reports and small case series described the occurrence of NOMI after cardiac surgery, [3][4][5][6][7][8] heart failure, 4,9 and a variety of heterogeneous acute critical illnesses. [9][10][11][12][13][14][15][16][17][18][19][20][21][22] Risk factors for NOMI appear to be older age as well as cardiovascular and/or chronic kidney disease (CKD) and it occurs especially in situations after major surgery, sepsis, and shock requiring vasopressor therapy. 23,24 Nonocclusive mesenteric ischemia is often only diagnosed in advanced stages of extensive intestinal necrosis, 24 leading to a devastating mortality rate up to 90% that has not changed over the past decades.…”

Section: Introductionmentioning

confidence: 99%

Nonocclusive Mesenteric Ischemia and Interventional Local Vasodilatory Therapy: A Meta-Analysis and Systematic Review of the Literature

Stahl

Rittgerodt

Busch

et al. 2019

J Intensive Care Med

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Background: Intensive care patients with nonocclusive mesenteric ischemia (NOMI) show mortality rates of 70% to 90%. Besides emergency surgery, different interventional local vasodilatory treatment (LVT) attempts have been described. We performed a systematic review and a meta-analysis to evaluate feasibility, efficacy, and tolerability of LVT in patients with life-threatening NOMI. Methods: Searches of PubMed, EMBASE, Web of Science, and Cochrane Library databases were performed until February 2019. Measured outcomes included immediate technical success rates (as indicated by mesenteric vasodilation on angiography or clinical improvement) and adverse events (AEs). Therapeutic efficacy was measured by the assessment of overall mortality. Results: Twelve studies (335 patients, 245 received LVT) from 1977 to 2018 were included. All studies were retrospective (4 comparative and 8 noncomparative). Different intra-arterial vasodilators (4× papaverine, 6× prostaglandin E1, 1× tolazoline/heparin, 1× tolazoline + iloprost) were reported. Initial technical success rate was 75.9% (95% confidence interval [CI], 55.1%-89%, P = .017) with an AE rate of 2.9% (95% CI: 1.3%-6.6%; P = .983). Overall mortality in LVT patients was 40.3% (95% CI: 28.7%-53%, P = .134). In 4 studies, outcomes were compared between patients receiving LVT to those who received standard of care (odds ratio for death in LVT patients was 0.261 [95% CI: 0.095-0.712, P = .009]). Conclusions: Local vasodilatory treatment appears to be safe in patients with NOMI and might have the potential to at least partially reverse mesenteric vasoconstriction features in control angiographies. However, with no randomized and prospective studies available yet, the overall quality of published studies has to be considered as low; therefore, it is not possible to draw generalizable conclusions from the present data concerning clinical end points. Its application might hold promise as a rescue treatment strategy and deserves further evaluation in randomized controlled trials.

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Section: Introductionmentioning

confidence: 99%

Nonocclusive Mesenteric Ischemia and Interventional Local Vasodilatory Therapy: A Meta-Analysis and Systematic Review of the Literature

Stahl

Rittgerodt

Busch

et al. 2019

J Intensive Care Med

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“…Methamphetamine can cause splanchnic vasoconstriction, so it follows that bowel ischemia may occur as a result. However, only a few case reports have confirmed this [[1], [2], [3], [4], [5]]. Herein we describe a rare case of intestinal ischemia due to methamphetamine use, managed at one of the metropolitan tertiary hospitals in Australia.…”

Section: Introductionmentioning

confidence: 85%

Intestinal ischemia due to methamphetamine use: A case report

Choi

Imrie

Lourie

et al. 2019

International Journal of Surgery Case Reports

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Highlights Methamphetamine is associated with non-occlusive intestinal ischemia. Splanchnic vasocontriction of mesenteric and colonic vessels is the most likely cause of methamphetamine-induced intestinal ischemia. Surgeons should have a high index of suspicion for intestinal ischemia in methamphetamine users who present with acute abdominal pain.

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“…Methamphetamine may lead to cardiovascular complications through catecholamine toxicity, due to its high-affinity interactions with binding sites on the dopamine, norepinephrine, and serotonin receptors (47). Several clinical and postmortem studies have reported an association between amphetamine use and cardiovascular disease (4)(5)(6)48,49), and several clinical case reports (9,10,26,50,51) have reported that methamphetamine use may be a cause of nonobstructive i n t e s t i n a l i s c h e m i a . O n e s t u d y r e p o r t e d t h a t methamphetamine use may be associated with significant microvascular compromise, which increases the risk of mesenteric ischemia (50); however, the mechanisms of these pathological responses in the intestinal tissue of methamphetamine users are still largely unknown (4).…”

Section: Methamphetamine Use Impairs Mesenteric Vasodilator Functionmentioning

confidence: 99%

“…Several clinical and postmortem studies have reported an association between amphetamine use and cardiovascular disease (4)(5)(6)48,49), and several clinical case reports (9,10,26,50,51) have reported that methamphetamine use may be a cause of nonobstructive i n t e s t i n a l i s c h e m i a . O n e s t u d y r e p o r t e d t h a t methamphetamine use may be associated with significant microvascular compromise, which increases the risk of mesenteric ischemia (50); however, the mechanisms of these pathological responses in the intestinal tissue of methamphetamine users are still largely unknown (4). In this study, enrichment analysis revealed that the DEGs were predominantly enriched in pathways associated with the hormone and cardiovascular systems, including adrenergic signaling in cardiomyocytes (mmu04261), renin secretion (mmu04924), cardiac muscle contraction (mmu04260), aldosterone synthesis and secretion (mmu04925), and vascular smooth muscle contraction (mmu04270).…”

Section: Methamphetamine Use Impairs Mesenteric Vasodilator Functionmentioning

confidence: 99%

Intestinal mRNA expression profile and bioinformatics analysis in a methamphetamine-induced mouse model of inflammatory bowel disease

Sun

Chen

et al. 2020

Ann Transl Med

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Background: Methamphetamine use has become a serious global public health problem and puts increasing burdens on healthcare services. Abdominal complications caused by methamphetamine use are uncommon and often go ignored by clinicians. The exact intestinal pathological alterations and transcriptomic responses associated with methamphetamine use are not well understood. This study sought to investigate the transcriptome in a methamphetamine-induced mouse model of inflammatory bowel disease (IBD) using next-generation RNA sequencing.Methods: Tissues from the ileum of methamphetamine-treated mice (n=5) and control mice (n=5) were dissected, processed and applied to RNA-sequencing. Bioinformatics and histopathological analysis were then performed. The expression profiles of intestinal tissue samples were analyzed and their expression profiles were integrated to obtain the differentially expressed genes and analyzed using bioinformatics. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses of the differentially expressed genes were performed using Metascape.Results: A total of 326 differentially expressed genes were identified; of these genes, 120 were upregulated and 206 were downregulated. The Gene Ontology analysis showed that the biological processes of the differentially expressed genes were focused primarily on the regulation of cellular catabolic processes, endocytosis, and autophagy. The main cellular components included the endoplasmic and endocytic vesicles, cytoskeleton, adherens junctions, focal adhesions, cell body, and lysosomes. Molecular functions included protein transferase, GTPase and proteinase activities, actin-binding, and protein-lipid complex binding.The Kyoto Encyclopedia of Genes and Genomes pathway analysis showed that the differentially expressed genes were mainly involved in bacterial invasion of epithelial cells, protein processing in the endoplasmic reticulum, regulation of the actin cytoskeleton, and T-cell receptor signaling pathways. A set of overlapping genes between IBD and methamphetamine-treated intestinal tissues was discovered. Conclusions:The present study is the first to analyze intestinal samples from methamphetamine-treated mice using high-throughput RNA sequencing. This study revealed key molecules that might be involved in

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Nonocclusive mesenteric ischemia in patients with methamphetamine use

Abstract: Therapeutic Case series study, level V.

Cited by 26 publications

References 27 publications

Nonocclusive Mesenteric Ischemia and Interventional Local Vasodilatory Therapy: A Meta-Analysis and Systematic Review of the Literature

Nonocclusive Mesenteric Ischemia and Interventional Local Vasodilatory Therapy: A Meta-Analysis and Systematic Review of the Literature

Intestinal ischemia due to methamphetamine use: A case report

Intestinal mRNA expression profile and bioinformatics analysis in a methamphetamine-induced mouse model of inflammatory bowel disease

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