Nonocclusive mesenteric infarction after cardiac surgery: potential biomarkers

Area of Science:

• Cardiology
• Gastroenterology
• Surgical Critical Care

Background:

• Nonocclusive mesenteric ischemia (NOMI) poses diagnostic challenges.
• Intestinal infarction is a severe complication of NOMI.
• Early diagnosis is crucial for patient outcomes.

Purpose of the Study:

• To prospectively evaluate plasma biomarkers for diagnosing intestinal infarction.
• To assess D-lactate, intestinal fatty acid-binding protein (i-FABP), and smooth muscle actin (SMA) as potential indicators.
• To correlate biomarker levels with laparotomy findings and patient survival post-cardiac surgery.

Main Methods:

• Prospective study of cardiac surgery patients requiring laparotomy for suspected NOMI.
• Measurement of pre-laparotomy plasma D-lactate, i-FABP, and SMA levels.
• Correlation of biomarker levels with laparotomy necessity, extent of resection, and survival.

Main Results:

• Thirteen of twenty patients underwent laparotomy.
• High SMA levels were associated with positive laparotomy findings (intestinal infarction).
• Decreased i-FABP and SMA levels were observed post-bowel resection, irrespective of survival.

Conclusions:

• Plasma biomarkers D-lactate, i-FABP, and SMA lack sufficient accuracy for reliable diagnosis of intestinal infarction.
• Elevated SMA warrants further investigation as a potential indicator of intestinal infarction.
• Increasing D-lactate post-intestinal resection may predict mortality.