Non-occlusive mesenteric ischemia and the role of cilostazol in its management

Murthy, K A Sudharshana; Kiran, H S; Cheluvaraj, Vijay; Bhograj, Abhijit

doi:10.4103/0976-500x.92513

Cited by 5 publications

(2 citation statements)

References 7 publications

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“… 26 , 30 Oral administration of phosphodiesterase inhibitors in non-intensive care patients was also attempted. 31 Intra-arterial perfusion with the prostacyclin iloprost was studied in patients with NOMI following cardiopulmonary bypass and showed positive effects. 32 Mitsuyoshi et al described in a small series of 9 patients the success of local prostaglandin E1 administration, which resulted in splanchnic vasodilation without systemic effects.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Analysis of Nonocclusive Mesenteric Ischemia in Medical and Surgical ICU Patients: Clinical Data on Demography, Clinical Signs, and Survival

Stahl

Busch

Maschke

et al. 2019

J Intensive Care Med

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Background: To analyze demography, clinical signs, and survival of intensive care patients diagnosed with nonocclusive mesenteric ischemia (NOMI) and to evaluate the effect of a local intra-arterial prostaglandin therapy. Methods: Retrospective observational study screening 455 intensive care patients with acute arterial mesenteric perfusion disorder in a tertiary care hospital within the past 8 years. Lastly, 32 patients with NOMI were enrolled, of which 11 received local intra-arterial prostaglandin therapy. The diagnosis of NOMI was based on the clinical presentation and established biphasic computed tomography criteria. Clinical and biochemical data were obtained 24 hours before, at the time, and 24 hours after diagnosis. Results: Patients were 60.5 (49.3-73) years old and had multiple comorbidities. Most of them were diagnosed with septic shock requiring high doses of norepinephrine (NE: 0.382 [0.249-0.627] μg/kg/min). The Sequential Organ Failure Assessment (SOFA) score was 18 (16-20). A decrease in oxygenation (Pao2/Fio2), pH, and bicarbonate and an increase in international normalized ratio, lactate, bilirubin, leucocyte count, and NE dose were early indicators of NOMI. Median SOFA score significantly increased in the last 24 hours before diagnosis of NOMI (16 vs 18, P < .0001). Overall, 28-day mortality was 75% (81% nonintervention vs 64% intervention cohort; P = .579). Median SOFA scores 24 hours after intervention increased by +5% in the nonintervention group and decreased by 5.5% in the intervention group ( P = .0059). Conclusions: Our data suggest that NOMI is a detrimental disease associated with progressive organ failure and a high mortality. Local intra-arterial prostaglandin application might hold promise as a rescue treatment strategy. These data encourage future randomized controlled trials are desirable.

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Section: Introductionmentioning

confidence: 99%

A Retrospective Analysis of Nonocclusive Mesenteric Ischemia in Medical and Surgical ICU Patients: Clinical Data on Demography, Clinical Signs, and Survival

Stahl

Busch

Maschke

et al. 2019

J Intensive Care Med

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“…Применение циластозола, по данным K. Murthy и соавт. [44], позволило купировать явления ишемии кишечника в течение недели у 2 пациентов с неокклюзионной формой ОНМзК.…”

Section: хирургия 1 2017unclassified

Non-occlusive form of acute mesenteric circulatory disorders: diagnosis and treatment

Хрипун

Alimov

Миронков

et al. 2017

Khir. Z. im. N.I. Pirogova

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Неокклюзионная форма острого нарушения мезентериального кровообращения: диагностика и лечение Д.м.н., проф. а.и. хриПун 1 , д.м.н., проф. а.н. аЛимОв 1 , к.м.н. а.Б. мирОнКОв 1, 2 , а.в. СавеЛьева 2 , д.м.н. а.Д. ПрямиКОв 1, 2 * 1 Кафедра хирургии и эндоскопии (зав.-д.м.н., проф. а.и. хрипун) факультета дополнительного профессионального образования ГБОу вПО «российский национально-исследовательский медицинский университет им. н.и. Пирогова», москва; 2 ГБуЗ «Городская клиническая больница им. в.м. Буянова» Департамента здравоохранения москвы (главный врач-к.м.н., доцент а.в. Саликов), москва, россия Ключевые слова: неокклюзионная форма острого нарушения мезентериального кровообращения, диагностика, лечение. Non-occlusive form of acute mesenteric circulatory disorders: diagnosis and treatment a.i. Khripun, a.n. aLimOv, a.B. mirOnKOv, a.v. SavELiEva, a.D. prYamiKOv Chair of surgery and endoscopy of the Department of advanced medical training of the n.i. pirogov's russian national research medical university, moscow, russian federation; v.m. Buyanov's City Clinical hospital, moscow, russia

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Comparison of open and endovascular treatment of acute mesenteric ischemia

Beaulieu

Arnaoutakis

Abularrage

et al. 2014

Journal of Vascular Surgery

175

129

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Endovascular intervention for AMI had increased significantly in the modern era. Among AMI patients undergoing revascularization, endovascular treatment was associated with decreased mortality and shorter length of stay. Furthermore, endovascular intervention was associated with lower rates of bowel resection and need for TPN. Further research is warranted to determine if increased use of endovascular repair could improve overall and gastrointestinal outcomes among patients requiring vascular repair for AMI.

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Non-occlusive mesenteric ischemia and the role of cilostazol in its management

Cited by 5 publications

References 7 publications

A Retrospective Analysis of Nonocclusive Mesenteric Ischemia in Medical and Surgical ICU Patients: Clinical Data on Demography, Clinical Signs, and Survival

A Retrospective Analysis of Nonocclusive Mesenteric Ischemia in Medical and Surgical ICU Patients: Clinical Data on Demography, Clinical Signs, and Survival

Non-occlusive form of acute mesenteric circulatory disorders: diagnosis and treatment

Comparison of open and endovascular treatment of acute mesenteric ischemia

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