ROLE OF LABORATORY METHODS IN INTEGRATED DIAGNOSTICS OF ACUTE MESENTERIAL ISCHEMIA


Cite item

Full Text

Abstract

The aim of the review: to present literature data on the role of laboratory methods in the complex diagnosis of acute mesenteric ischemia. The main provisions. To search for scientific publications, we used the PubMed database, the RSCI, the Google Scholar search engine, as well as cited references. Articles relevant to the purpose of the review were selected for the period from 1999 to 2019 in the following terms: “acute mesenteric ischemia”, “pathogenesis”, “diagnosis”, “biomarkers”. Inclusion criteria were limited to acute arterial mesenteric ischemia. Acute mesenteric ischemia is an emergency condition caused by a sudden violation of the blood flow through the mesenteric vessels, which rapidly progresses to a heart attack of the intestinal wall and is accompanied by high mortality. Four main mechanisms of OMI are distinguished: embolism from the left parts of the heart or aorta, thrombosis of arteries or veins of the intestine, non-occlusive acute mesenteric ischemia (NOMI), due to vascular spasm. In this case, destructive disorders occur in the intestinal wall, starting from the mucous membrane to the serous, which leads to bacterial translocation and the development of a systemic inflammatory response syndrome. Early bowel revascularization is a key factor in reducing complications and mortality associated with it. However, in the initial stages of the disease has no specific signs, which complicate its diagnosis. The only way to detect mesenteric blood flow disorders is MSCT with angiography, and with non-occlusive lesions, mesenteric angiography, which in normal clinical practice is not always possible. Conclusion. It can be assumed that the use of laboratory methods will expand the range of diagnostic measures and will make it possible to conduct timely treatment aimed at restoring the mesenteric blood flow and improve the prognosis in patients with acute mesenteric ischemia.

About the authors

Dmitry V. Belov

Federal Center for Cardiovascular Surgery; South Ural State Medical University

Email: belof20@ya.ru
candidate of medical sciences, Associate Professor of the Department of Hospital Surgery, cardiovascular surgeon, Federal Center for Cardiovascular Surgery, 454003, Chelyabinsk, Russian Federation 454003, Chelyabinsk, Russian Federation; 454092, Chelyabinsk, Russian Federation

D. V Garbuzenko

South Ural State Medical University

454092, Chelyabinsk, Russian Federation

O. P Lukin

Federal Center for Cardiovascular Surgery; South Ural State Medical University

454003, Chelyabinsk, Russian Federation; 454092, Chelyabinsk, Russian Federation

S. S Anufrieva

South Ural State Medical University

454092, Chelyabinsk, Russian Federation

References

  1. Khan S.M., Emile S.H., Wang Z., Agha M.A. Diagnostic accuracy of hematological parameters in Acute mesenteric ischemia-A systematic review. Int J Surg. 2019; 66: 18-27. doi: 10.1016/j.ijsu.2019.04.005
  2. Acosta S., Ogren M., Sternby N.H., Bergqvist D., Bjorck M. Fatal nonocclusive mesenteric ischaemia: populationbased incidence and risk factors. J Int Med. 2006; 259(3): 305-13. doi: 10.1111/j.1365-2796.2006.01613.x
  3. Белов Д.В., Гарбузенко Д.В., Фокин А.А., Милиевская Е.Б. Факторы риска развития абдоминальных осложнений после коронарного шунтирования. Бюллетень НЦССХ им. А.Н. Бакулева РАМН Сердечно-сосудистые заболевания. 2018; 19(6): 794-9. doi: org/10.24022/1810-0694-2018-19-6-794-799
  4. Белов Д.В., Гарбузенко Д.В., Фокин А.А., Наймушина Ю.В., Милиевская Е.Б., Лукин О.П., Пешиков О.В. Шкала прогнозирования риска ранних абдоминальных осложнений после коронарного шунтирования в условиях искусственного кровообращения. Грудная и сердечно-сосудистая хирургия. 2019; 61 (3): 190-6. doi.org/10.24022/0236-2791-2019-61-3-190-196
  5. Bjorck M., Koelemay M., Acosta S., Bastos Goncalves F., Kolbel T., Kolkman J.J. et al. Editor’s Choice Management of the Diseases of Mesenteric Arteries and Veins Clinical Practice Guidelines of the European Society of Vascular Surgery (ESVS). Eur. J. Vasc. Endovasc. Surg. 2017; 53: 460-510. doi: 10.1016/j.ejvs.2017.01.010
  6. Bjorck M., Wanhainen A. Nonocclusive mesenteric hypoperfusion syndromes: recognition and treatment. Semin Vasc Surg. 2010; 23(1): 54-64. doi: 10.1053/j.semvascsurg.2009.12.009
  7. Kirkpatrick A.W., Roberts D.J., De Waele J., Jaeschke R., Malbrain M.L., De Keulenaer B. et al. Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med. 2013; 39(7):1190-206. doi: 10.1007/s00134-013-2906-z
  8. Ceppa E., Fuh K., Bulkley G. Mesenteric hemodynamic response to circulatory shock. Curr Opin Crit Care. 2003; 9(2):127-32.
  9. Haglund U., Bergqvist D. Intestinal ischemia-the basics. Langenbecks Arch Surg. 1999; 384(3): 233-8.
  10. Vollmar B., Menger M. Intestinal ischemia/reperfusion: microcirculatory pathology and functional consequences. Langenbecks Arch Surg. 2010; 396(1): 13-29. doi: 10.1007/s00423-010-0727-x
  11. Paterno F., Longo W. The etiology and pathogenesis of vascular disorders of the intestine. Radiol Clin North Am. 2008; 46(5): 877-85. doi: 10.1016/j.rcl.2008.06.005
  12. Al-Diery H., Phillips A., Evennett N., Pandanaboyana S., Gilham M., Windsor J.A. The Pathogenesis of Nonocclusive Mesenteric Ischemia: Implications for Research and Clinical Practice. J Intensive Care Med. 2019; 34(10): 771-81. doi: 10.1177/0885066618788827
  13. Peoc’h K., Nuzzo A., Guedj K., Paugam C., Corcos O. Diagnosis biomarkers in acute intestinal ischemic injury: so close, yet so far. Clin Chem Lab Med. 2018; 56(3):373-85. doi: 10.1515/cclm-2017-0291
  14. Гарбузенко Д.В. Роль микрофлоры кишечника в развитии осложнений портальной гипертензии при циррозе печени. Клиническая медицина. 2007; 85(8): 15-9.
  15. Гарбузенко Д.В., Микуров А.А. Роль эндотоксемии в развитии кровотечений из варикозно-расширенных вен пищевода у больных циррозом печени. Российский медицинский журнал. 2011; 6: 47-9.
  16. Altshuler A.E., Richter M.D., Modestino A.E., Penn A.H., Heller M.J., Schmid-Schonbein G.W. Removal of luminal content protects the small intestine during hemorrhagic shock but is not sufficient to prevent lung injury. Physiol Rep. 2013; 1: e00109. doi: 10.1002/phy2.109
  17. Fishman J.E., Sheth S.U., Levy G., Alli V., Lu Q., Xu D. et al. Intraluminal nonbacterial intestinal components control gut and lung injury after trauma hemorrhagic shock. Ann Surg. 2014; 260: 1112-20. doi: 10.1097/SLA.0000000000000631
  18. Chang M., Kistler E.B., Schmid-Schonbein G.W. Disruption of the mucosal barrier during gut ischemia allows entry of digestive enzymes into the intestinal wall. Shock. 2012; 37: 297-305. doi: 10.1097/SHK.0b013e318240b59b
  19. Bala M., Kashuk J., Moore E.E., Kluger Y., Biffl W., Gomes C.A. et al. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World J. Emerg. Surg. 2017; 12: 38. doi: 10.1186/s13017-017-0150-5
  20. Emile S.H. Predictive Factors for Intestinal Transmural Necrosis in Patients with Acute Mesenteric Ischemia. World J Surg. 2018; 42: 2364-72. doi: 10.1007/s00268-018-4503-3
  21. Montagnana M., Danese E., Lippi G. Biochemical markers of acute intestinal ischemia: possibilities and limitations. Ann Transl Med. 2018; 6(17): 341.doi: 10.21037/atm.2018.07.22
  22. Evennett N.J., Petrov M.S., Mittal A., Windsor J.A. Systematic review and pooled estimates for the diagnostic accuracy of serological markers for intestinal ischemia. World J Surg. 2009; 33:1374-83. doi: 10.1007/s00268-009-0074-7.
  23. Matsumoto S., Sekine K., Funaoka H., Yamazaki M., Shimizu M., Hayashida K., Kitano M. Diagnostic performance of plasma biomarkers in patients with acute intestinal ischaemia. Br J Surg. 2014; 101: 232-8. doi: 10.1002/bjs.9331
  24. Thuijls G., van Wijck K., Grootjans J., Derikx J.P., van Bijnen A.A, Heineman E. et al. Early diagnosis of intestinal ischemia using urinary and plasma fatty acid binding proteins. Ann Surg. 2011; 253: 303-8. doi: 10.1097/SLA.0b013e318207a767
  25. Aktimur R., Cetinkunar S., Yildirim K., Aktimur S.H., Ugurlucan M., Ozlem N. Neutrophil-to-lymphocyte ratio as a diagnostic biomarker for the diagnosis of acute mesenteric ischemia. Eur J Trauma Emerg Surg. 2016; 42(3): 363-8. doi: 10.1007/s00068-015-0546-4
  26. Tanrıkulu Y., Şen Tanrıkulu C., Sabuncuoğlu M.Z., Temiz A., Köktürk F., Yalçın B. Diagnostic utility of the neutrophil-lymphocyte ratio in patients with acute mesenteric ischemia: A retrospective cohort study. Ulus Travma Acil Cerrahi Derg. 2016; 22(4): 344-9. doi: 10.5505/tjtes.2015.28235
  27. Ewaschuk J.B., Naylor J.M., Zello G.A. D-lactate in human and ruminant metabolism. J Nutr. 2005; 135: 1619-25. doi: 10.1093/jn/135.7.1619
  28. Collange O., Tamion F., Meyer N., Quillard M., Kindo M., Hue G. et al. Early detection of gut ischemia-reperfusion injury during aortic abdominal aneurysmectomy: a pilot, observational study. J Cardiothorac Vasc Anesth. 2013; 27: 690-5. doi: 10.1053/j.jvca.2013.01.018
  29. Treskes N., Persoon A.M., van Zanten A.R.H. Diagnostic accuracy of novel serological biomarkers to detect acute mesenteric ischemia: a systematic review and meta-analysis. Intern Emerg Med. 2017; 12(6): 821-36. doi: 10.1007/s11739-017-1668-y
  30. Piton G., Capellier G. Biomarkers of gut barrier failure in the ICU. Curr Opin Crit Care. 2016; 22: 152-60. doi: 10.1097/MCC.0000000000000283.
  31. Khadaroo R.G., Fortis S., Salim S.Y., Streutker C., Churchill T.A., Zhang H. I-FABP as biomarker for the early diagnosis of acute mesenteric ischemia and resultant lung injury. PLoS One. 2014; 9: e115242. doi: 10.1371/journal.pone.0115242
  32. Sun D.L., Cen Y.Y., Li S.M., Li W.M., Lu Q.P., Xu P.Y. Accuracy of the serum intestinal fatty-acid-binding protein for diagnosis of acute intestinal ischemia: a meta-analysis. Sci Rep. 2016; 6: 34371. doi: 10.1038/srep34371
  33. Schellekens D.H., Grootjans J., Dello S.A., van Bijnen A.A., van Dam R.M., Dejong C.H. et al. Plasma intestinal fatty acid-binding protein levels correlate with morphologic epithelial intestinal damage in a human translational ischemia-reperfusion model. J Clin Gastroenterol. 2014; 48: 253-60. doi: 10.1097/MCG.0b013e3182a87e3e
  34. Tan W.W., Zhang M. Clinical value of D-dimer for early diagnosis and severity of ischemic bowel disease. Lab Med Clin. 2016; 13: 1497-9. doi: 10.1097/MD.0000000000000270
  35. Block T., Nilsson T.K., Björck M., Acosta S. Diagnostic accuracy of plasma biomarkers for intestinal ischaemia. Scand J Clin Lab Invest. 2008; 68: 242-8. doi: 10.1080/00365510701646264
  36. Yang K., Wang W., Zhang W.H., Chen X.L., Zhou J., Chen X.Z. et al. The combination of D-dimer and peritoneal irritation signs as a potential indicator to exclude the diagnosis of intestinal necrosis. Med Baltim. 2015; 94: e1564. doi: 10.1097/MD.0000000000001564
  37. Белов Д.В., Гарбузенко Д.В., Милиевская Е.Б., Бордуновский В.Н. Ранние абдоминальные осложнения после коронарного шунтирования в условиях искусственного кровообращения: диагностика и лечение. Бюллетень НЦССХ им. А.Н. Бакулева РАМН Сердечно-сосудистые заболевания. 2019; 20(4): 305-12. doi:org/10.24022/1810-0694-2019-20-4-305-312
  38. Oliva I.B., Davarpanah A.H., Rybicki F.J., Desjardins B., Flamm S.D., Francois C.J. et al. ACR Appropriateness Criteria (R) imaging of mesenteric ischemia. Abdom Imaging. 2013; 38(4): 714-9. doi: 10.1007/s00261-012-9975-2
  39. Wadman M., Block T., Ekberg O., Syk I., Elmstahl S., Acosta S. Impact of MDCT with intravenous contrast on the survival in patients with acute superior mesenteric artery occlusion. Emerg Radiol. 2010; 17(3):171-8. doi: 10.1007/s10140-009-0828-4
  40. Гарбузенко Д.В., Белов Д.В., Шустова Ю.С. Редкое осложнение кардиохирургических вмешательств: синдром огилви (описание клинического случая и обзор литературы). Грудная и сердечно-сосудистая хирургия. 2018; 60 (3): 261-4. doi: org/10.24022/0236-2791-2018-60-3-261-264
  41. Trompeter M., Brazda T., Remy C.T., Vestring T., Reimer P. Nonocclusive mesenteric ischemia: etiology, diagnosis, and interventional therapy. Eur Radiol. 2002; 12(5):1179-87. doi: 10.1007/s00330-001-1220-2
  42. Gunduz A., Turkmen S., Turedi S., Mentese A., Yulug E., Ulusoy H. et al. Time-dependent variations in ischemia-modified albumin levels in mesenteric ischemia. Acad Emerg Med. 2009;16: 539-43. doi: 10.1111/j.1553-2712.2009.00414.x
  43. Lebrun L.J., Grober J.Could glucagon-like peptide-1 be a potential biomarker of early-stage intestinal ischemia? Biochimie. 2019; 159:107-111. doi: 10.1016/j.biochi.2018.11.009
  44. Lammers K.M., Innocenti G., Venturi A., Rizzello F., Helwig U., Bianchi G.P. et al. The effect of transient intestinal ischemia on inflammatory parameters. Int J Colorectal Dis. 2003;18: 78-85. doi: 10.1007/s00384-002-0413-8
  45. Linder A., Arnold R., Boyd J.H., Zindovic M., Zindovic I., Lange A. et al. Heparin-Binding Protein Measurement Improves the Prediction of Severe Infection With Organ Dysfunction in the Emergency Department. Crit Care Med. 2015; 43: 2378-86. doi: 10.1097/CCM.0000000000001265
  46. Kocak S., Acar T., Ertekin B., Güven M., Dundar Z.D. The role of heparin-binding protein in the diagnosis of acute mesenteric ischemia. Ulus Travma Acil Cerrahi Derg. 2019; 25(3): 205-12. doi: 10.5505/tjtes.2018.49139
  47. Masson S., Caironi P., Fanizza C., Thomae R., Bernasconi R., Noto A. et al. Circulating presepsin (soluble CD14 subtype) as a marker of host response in patients with severe sepsis or septic shock: Data from the multicenter, randomized ALBIOS trial. Intensive Care Med. 2015; 41:12-20 doi: 10.1007/s00134-014-3514-2
  48. Stroeder J., Bomberg H., Wagenpfeil S., Buecker A., Schaefers H.J., Katoh M. et al. Presepsin and Inflammatory Markers Correlate With Occurrence and Severity of Nonocclusive Mesenteric Ischemia After Cardiovascular Surgery. Crit Care Med. 2018; 46(6):e575-e583. doi: 10.1097/CCM.0000000000003091
  49. Cosse C., Sabbagh C., Kamel S., Galmiche A., Regimbeau J.M. Procalcitonin and intestinal ischemia: a review of the literature. World J Gastroenterol. 2014; 20:17773-8. doi: 10.3748/wjg.v20.i47.17773
  50. Derikx J.P., Schellekens D.H., Acosta S. Serological markers for human intestinal ischemia: A systematic review. Best Pract Res Clin Gastroenterol. 2017; 31(1): 69-74. doi: 10.1016/j.bpg.2017.01.004
  51. Cosse C., Sabbagh C., Browet F., Mauvais F., Rebibo L., Zogheib E. et al. Serum value of procalcitonin as a marker of intestinal damages: type, extension, and prognosis. Surg Endosc. 2015; 29: 3132-9. doi: 10.1007/s00464-014-4038-0
  52. Fragkos K.C., Forbes A. Citrulline as a marker of intestinal function and absorption in clinical settings: A systematic review and meta-analysis. United European Gastroenterol J. 2018; 6:181-91. doi: 10.1177/2050640617737632
  53. Schellekens D.H.S.M., Reisinger K.W., Lenaerts K., Hadfoune M., Olde Damink S.W., Buurman W.A. et al. SM22 a Plasma Biomarker for Human Transmural Intestinal Ischemia. Ann Surg. 2018; 268:120-6. doi: 10.1097/SLA.0000000000002278

Copyright (c) 2019 Eco-Vector


 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies