title: Alterations of mesenteric blood flow after cardiopulmonary bypass: a Doppler sonographic study.
abstract: OBJECTIVE
  Mesenteric ischemia after cardiopulmonary bypass is a serious complication associated with high mortality. It was the aim of this study to investigate mesenteric blood flow with the help of Doppler sonography in asymptomatic patients before and after cardiopulmonary bypass and cardiac surgery.
  
  
  METHODS
  Observational study of consecutive patients.
  
  
  METHODS
  Nonuniversity cardiac center.
  
  
  METHODS
  Twenty-five patients undergoing elective coronary revascularization with normal left ventricular function and stable postoperative circulations with no need for catecholamines.
  
  
  RESULTS
  Preoperative and postoperative color and CW-Doppler sonography of the superior mesenteric artery. Diameter of the superior mesenteric artery and the Doppler flow profile were analyzed. Preoperative and postoperative hemodynamic data were measured by using a pulmonary artery thermodilution catheter. Mesenteric systolic flow velocity was 135 +/- 11 cm/s preoperatively and 193 +/- 13 cm/s postoperatively (p < 0.05). The corresponding preoperative and postoperative values of diastolic flow velocity were 14 +/- 4 and 4 +/- 2 cm/s (p < 0.05) and the values of mean flow velocity were 24 +/- 3 and 17 +/- 2 cm/s (p < 0.05), respectively. The preoperative Pourcelot resistive index was 0.87 +/- 0.05, and the preoperative Gosling pulsatility index was 4.6 +/- 0.5. Both indices increased postoperatively to values of 0.98 +/- 0.04 and 9.5 +/- 0.7, respectively (p < 0.05). Preoperative and postoperative hemodynamic data did not differ significantly.
  
  
  CONCLUSIONS
  The postoperative changes in the flow velocities and the increases of the resistive and pulsatility index are indications of rigidity of the mesenteric vascular bed and decreased mesenteric perfusion after cardiopulmonary bypass.
authors.affiliation: Department of Cardiothoracic Surgery, Völklingen Heart Centre, Völklingen/Saar, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Straub
authors.forename: Johannes
authors.initials: J
authors.lastname: Winning
authors.forename: Peter
authors.initials: P
authors.lastname: Greilach
authors.forename: Helmut
authors.initials: H
authors.lastname: Isringhaus
authors.forename: Gerhard
authors.initials: G
authors.lastname: Kalweit
authors.forename: Hanno
authors.initials: H
authors.lastname: Huwer
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D002315:Cardiopulmonary Bypass / Q000379:methods*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013152:Splanchnic Circulation / Q000502:physiology*; D018608:Ultrasonography, Doppler / Q000379:methods*; D014655:Vascular Resistance / Q000502:physiology