Gastrointestinal dysfunction following cardiac surgery
Gastrointestinal dysfunction following cardiac surgery
Cardiac surgery is associated with a low incidence of GI complications, but with a disproportionate mortality. A number of risk factors have become established which identify patients at risk. CPB is associated with profound reductions in mucosal blood flow. Mesenteric perfusion is altered by primary endothelial dysfunction, which may further be exacerbated by the use of vasoconstrictors during CPB; inflammatory mediators can 'prime' the mesenteric vasculature. Cardiac surgery with or without CPB is associated with increased tissue oxygen demands, particularly by the splanchnic bed. The disparity in general and regional oxygen supply and demand results in the development of mucosal hypoxia and this cannot be attributed to CPB alone. This injury is measurable by reductions in both absorptive and barrier functions of the gut. Protection may be conferred by modulating the perfusion protocol during bypass and pharmacological interventions which modify the inflammatory response to surgery.
215-223
Ohri, Sunil K.
8aa5698c-78cf-4f59-a5af-5afa46f0348c
Velissaris, Theo
9bbae412-a1e9-4570-a6d4-0c04bbd163ea
1 July 2006
Ohri, Sunil K.
8aa5698c-78cf-4f59-a5af-5afa46f0348c
Velissaris, Theo
9bbae412-a1e9-4570-a6d4-0c04bbd163ea
Ohri, Sunil K. and Velissaris, Theo
(2006)
Gastrointestinal dysfunction following cardiac surgery.
Perfusion, 21 (4), .
Abstract
Cardiac surgery is associated with a low incidence of GI complications, but with a disproportionate mortality. A number of risk factors have become established which identify patients at risk. CPB is associated with profound reductions in mucosal blood flow. Mesenteric perfusion is altered by primary endothelial dysfunction, which may further be exacerbated by the use of vasoconstrictors during CPB; inflammatory mediators can 'prime' the mesenteric vasculature. Cardiac surgery with or without CPB is associated with increased tissue oxygen demands, particularly by the splanchnic bed. The disparity in general and regional oxygen supply and demand results in the development of mucosal hypoxia and this cannot be attributed to CPB alone. This injury is measurable by reductions in both absorptive and barrier functions of the gut. Protection may be conferred by modulating the perfusion protocol during bypass and pharmacological interventions which modify the inflammatory response to surgery.
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Published date: 1 July 2006
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Local EPrints ID: 61402
URI: http://eprints.soton.ac.uk/id/eprint/61402
ISSN: 0267-6591
PURE UUID: b196cb99-7964-4c43-9a72-daf8f6d4ea10
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Date deposited: 01 Apr 2009
Last modified: 08 Jan 2022 01:13
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Author:
Sunil K. Ohri
Author:
Theo Velissaris
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