Nonocclusive mesenteric infarction after cardiac surgery: potential biomarkers.
J Surg Res
; 211: 21-29, 2017 05 01.
Article
en En
| MEDLINE
| ID: mdl-28501119
ABSTRACT
BACKGROUND:
Nonocclusive mesenteric ischemia can cause intestinal infarction but the diagnosis is challenging. This prospective study evaluated three plasma biomarkers of intestinal infarction after cardiac surgery. MATERIALS ANDMETHODS:
Patients were recruited after cardiac surgery if they required laparotomy (with or without intestinal resection) for suspected nonocclusive mesenteric ischemia. Plasma levels of D-lactate, intestinal fatty acid-binding protein (i-FABP), and smooth muscle actin (SMA) before laparotomy were measured.RESULTS:
Twenty patients were recruited (68 ± 9 y, EuroSCORE 8.7 ± 2.8, mortality 70%). A positive laparotomy (n = 13) was associated with no change in D-lactate (P = 0.95), decreased i-FABP (P = 0.007), and increased SMA (P = 0.01). All patients with high SMA had a positive laparotomy. A subgroup analysis was undertaken in the eight patients who required multiple laparotomies. D-lactate increased between the two laparotomies in nonsurvivors (n = 4). Plasma i-FABP (P = 0.008) and SMA (P = 0.036) significantly decreased after the bowel resection, regardless of survival outcome.CONCLUSIONS:
None of the biomarkers were accurate enough to reliably diagnose intestinal infarction. However, all patients with high values of SMA developed intestinal infarction, thus warranting further investigation. An increasing D-lactate after intestinal resection suggests impending death.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Actinas
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Ácido Láctico
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Proteínas de Unión a Ácidos Grasos
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Isquemia Mesentérica
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Procedimientos Quirúrgicos Cardíacos
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Infarto
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2017
Tipo del documento:
Article