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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
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Risk factor analysis for nonocclusive mesenteric ischemia following cardiac surgery: A case-control study
Ju Yong Lim1, Joon Bum Kim, Sung Ho Jung
1Departments of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Medicine
|September 15, 2017
Summary
Post-cardiac surgery nonocclusive mesenteric ischemia (NOMI) is rare but serious. Key risk factors include older age, high vasoactive-inotropic score, and persistent high lactate levels in the first 24 hours post-surgery.
Area of Science:
- Cardiology
- Gastroenterology
- Surgical Critical Care
Background:
- Post-cardiac surgery nonocclusive mesenteric ischemia (NOMI) is a rare but life-threatening complication.
- Early detection and intervention are crucial for improving patient outcomes.
Purpose of the Study:
- To identify clinical features and risk factors for NOMI in the immediate postoperative period after cardiac surgery.
- To establish prognostic indicators for NOMI patients.
Main Methods:
- Retrospective review of 9445 cardiac surgery patients over 9 years.
- Analysis of 40 NOMI cases requiring surgical intervention.
- Logistic regression analysis comparing NOMI cases with a control group (1:3 ratio) to identify risk factors.
Main Results:
- NOMI was diagnosed a mean of 8.1 days post-surgery.
- Identified risk factors include older age (OR 1.16), high vasoactive-inotropic score (VIS), and maximal lactate level on postoperative day 0 (OR 1.23).
- Persistent hyperlactatemia without washout during the first 48 hours was observed in NOMI cases (P=.04).
Conclusions:
- Old age, high-dose vasoactive-inotropic use, and persistent high lactate levels in the first 24 hours post-surgery are significant risk factors for NOMI.
- Lactic acidosis and extensive bowel necrosis at exploration are associated with poor survival rates.
