title: Intestinal ischemia/reperfusion: microcirculatory pathology and functional consequences.
abstract: BACKGROUND
  Intestinal ischemia and reperfusion (I/R) is a challenging and life-threatening clinical problem with diverse causes. The delay in diagnosis and treatment contributes to the continued high in-hospital mortality rate.
  
  
  RESULTS
  Experimental research during the last decades could demonstrate that microcirculatory dysfunctions are determinants for the manifestation and propagation of intestinal I/R injury. Key features are nutritive perfusion failure, inflammatory cell response, mediator surge and breakdown of the epithelial barrier function with bacterial translocation, and development of a systemic inflammatory response. This review provides novel insight into the basic mechanisms of damaged intestinal microcirculation and covers therapeutic targets to attenuate intestinal I/R injury.
  
  
  CONCLUSIONS
  The opportunity now exists to apply this insight into the translation of experimental data to clinical trial-based research. Understanding the basic events triggered by intestinal I/R may offer new diagnostic and therapeutic options in order to achieve improved outcome of patients with intestinal I/R injury.
authors.affiliation: Institute for Experimental Surgery, University of Rostock, Schillingallee 69a, 18055, Rostock, Germany. brigitte.vollmar@med.uni-rostock.de
authors.forename: Brigitte
authors.initials: B
authors.lastname: Vollmar
authors.forename: Michael D
authors.initials: MD
authors.lastname: Menger
mesh_terms: D000818:Animals; D018988:Bacterial Translocation / Q000502:physiology; D003937:Diagnosis, Differential; D004211:Disseminated Intravascular Coagulation / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D042241:Early Diagnosis; D006801:Humans; D018836:Inflammation Mediators / Q000502:physiology; D007408:Intestinal Absorption / Q000502:physiology; D007413:Intestinal Mucosa / Q000098:blood supply / Q000473:pathology; D007422:Intestines / Q000098:blood supply* / Q000473:pathology; D007511:Ischemia / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D019194:Ischemic Preconditioning; D008641:Mesenteric Vascular Occlusion / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D008643:Mesentery / Q000098:blood supply* / Q000473:pathology; D008833:Microcirculation / Q000502:physiology*; D011379:Prognosis; D015427:Reperfusion Injury / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D018746:Systemic Inflammatory Response Syndrome / Q000473:pathology / Q000503:physiopathology / Q000601:surgery
chemical_list: D018836:Inflammation Mediators