Early diagnosis of acute mesenteric ischemia after cardiopulmonary bypass.
BACKGROUND
The aim of this study is to identify significant risk factors and eventual clinical markers associated with acute mesenteric ischemia (AMI) after cardiopulmonary bypass.


METHODS
The study was retrospectively performed on a group of 19 patients (group A) undergoing cardiac surgery between January 1991 and December 1999, who developed AMI within 30 days of their hospitalization. A control group of 48 patients (group B) was compared in order to define preoperative and operative risk factors for AMI.


RESULTS
At the abdominal operation, a non-occlusive mesenteric ischemia was found in every case. In-hospital mortality was 84.2% (16/19). Compared to the control, there was a significant difference in aortic cross-clamp time (p<0.001) and use of inotropic drugs (p<0.01). Postoperatively, the studied group (group A) had a significantly higher mean value of the enzymatic serum levels at any time.


CONCLUSIONS
A high index of suspicion for mesenteric ischemia after cardiopulmonary bypass should be considered in patients with conditions of hypoperfusion. The early laboratory signs of AMI might be searched during the first postoperative hours.
Division of Cardiac Surgery, Tor Vergata University of Rome, Italy.
M
M
Garofalo
R
R
Borioni
P
P
Nardi
F
F
Turani
F
F
Bertoldo
S
S
Forlani
A
A
Pellegrino
L
L
Chiariello
D000208:Acute Disease; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D002315:Cardiopulmonary Bypass; D016022:Case-Control Studies; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000175:diagnosis* / Q000209:etiology; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007964:Leukocytosis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D003402:Creatine Kinase