Abdominal organ injury after cardiac surgery.
Gastrointestinal complications occur in about 2.5% of patients undergoing cardiac surgery, are associated with a high mortality (about 33%), and account for nearly 15% (and perhaps increasing) of all postoperative deaths. The various complications and risk factors are reviewed. Splanchnic ischemia prior to, during, and especially postoperatively appears to be an important cause of these complications. In addition, splanchnic ischemia is hypothesized to be one cause of the systemic inflammatory response syndrome and multiorgan failure that may follow cardiac surgery. The physiology of splanchic perfusion and the effects of cardiac surgery, including cardiopulmonary bypass, on it are reviewed. Finally, possible methods to minimize splanchnic ischemia and reduce the incidence of abdominal complications are discussed.
Hessel
Eugene A
EA
University of Kentucky College of Medicine, Lexington, Kentucky, USA. ehessel@uky.edu
D000005:Abdomen / Q000473:pathology*; D000818:Animals; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002764:Cholecystitis / Q000209:etiology / Q000473:pathology / Q000628:therapy; D005767:Gastrointestinal Diseases / Q000209:etiology* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D017093:Liver Failure / Q000209:etiology / Q000473:pathology / Q000628:therapy; D011183:Postoperative Complications / Q000473:pathology* / Q000628:therapy