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Updated: Jul 3, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Bronchoscopy is associated with decreased mesenteric arterial flow
Ali Nayci1, Sibel Atis, Meltem Nass Duce
1Department of Pediatric Surgery, Mersin University School of Medicine, Mersin Turkey. anayci@mersin.edu.tr
Background:
We hypothesized that fiberoptic bronchoscopy can contribute to mesenteric ischemia and bacterial translocation.
Objective:
To test this hypothesis we investigated in patients undergoing bronchoscopy mesenteric blood flow and markers in association with ischemia reperfusion injury.
Patient:
Forty-seven consecutive patients requiring diagnostic fiberoptic bronchoscopy were studied.
Measurements:
Parameters evaluated were superior mesenteric artery Doppler sonography, oxidative stress mediators, arterial blood gases, blood cultures pre-fiberoptic bronchoscopy, and 1st, 4th, and 24th hr post-fiberoptic bronchoscopy.
Main Results:
After bronchoscopy; PaO2 decreased by 21.8% +/- 1.5% (range 6-40), and remained low at all time points (p = 0.0001, p = 0.0001, p = 0.008). Flow volume decreased by 38.8% +/- 14.9% (range 6-72), and remained low at 1st and 4th hr (p = 0.0001, p = 0.01). Resistive and pulsatile index increased at 1st hr (p = 0.0001, p = 0.001) and 4th hr (p = 0.018, p = 0.045). Myeloperoxidase and malondialdehyde increased at 1st hr (p = 0.0001) and 4th hr (p = 0.037, p = 0.028). Corresponding glutathione and catalase decreased at 1st hr (p = 0.0001), and glutathione remained significant at 4th and 24th hr (p = 0.0001, p = 0.003). Correlation between flow volume and PaO2 (r = .71, p = 0.0001), myeloperoxidase (r = -.39, p = 0.05), glutathione (r = .41, p = 0.03) was significant. Nine of 47 (19.1%) had fever, and 3 of 47 (6.4%) had gram-negative bacteremia.
Conclusion:
Fiberoptic bronchoscopy is associated with decreased mesenteric blood flow, which may place the patient at risk for mesenteric ischemia and gastrointestinal bacterial translocation.
Insights
Fiberoptic bronchoscopy may reduce mesenteric blood flow, increasing risks of ischemia and bacterial translocation. This study monitored blood flow and ischemia markers post-procedure in patients.
Area of Science:
- Gastroenterology
- Pulmonology
- Surgical Critical Care
Background:
- Fiberoptic bronchoscopy (FOB) is a common diagnostic procedure.
- A potential complication of FOB is mesenteric ischemia and bacterial translocation, though not well-established.
Purpose of the Study:
- To investigate the impact of FOB on mesenteric blood flow.
- To assess markers of ischemia-reperfusion injury and bacterial translocation post-FOB.
Main Methods:
- 47 patients undergoing FOB were studied.
- Mesenteric blood flow was assessed using Doppler sonography.
- Oxidative stress markers, blood gases, and blood cultures were analyzed pre- and post-procedure.
Main Results:
- FOB led to significant decreases in PaO2 and mesenteric blood flow volume.
- Increased markers of oxidative stress (myeloperoxidase, malondialdehyde) and indices of vascular resistance were observed.
- Bacteremia occurred in 6.4% of patients, with 19.1% developing fever.
Conclusions:
- Fiberoptic bronchoscopy is associated with reduced mesenteric blood flow.
- This reduction may elevate the risk of mesenteric ischemia and bacterial translocation in patients.
