Mirko Barone, Regina Frontera, Rita Vaia Liouras, Massimo Ippoliti, Luca Serano, Carmine Giovanni Iovino, I. Dell’Atti, Luigi Vetrugno, F. Mucilli, S. M. Maggiore
{"title":"危重病人的非闭塞性肠系膜缺血:床旁腹腔镜检查是否真正有益?","authors":"Mirko Barone, Regina Frontera, Rita Vaia Liouras, Massimo Ippoliti, Luca Serano, Carmine Giovanni Iovino, I. Dell’Atti, Luigi Vetrugno, F. Mucilli, S. M. Maggiore","doi":"10.1097/ec9.0000000000000107","DOIUrl":null,"url":null,"abstract":"\n Non-occlusive mesenteric ischemia in critically ill patients still has a poor prognosis. Despite several established risk factors, the interaction between clinical conditions and perfusion mismatch often leads to progressive organ failure. Workup is challenging because of the absence of typical abdominal signs and symptoms due to sedation, poor reactivity, need for ventilation, and confounding comorbidities. Moreover, imaging has poor specificity with findings often inconclusive. A bedside exploratory laparoscopy, as a complementary strategy, would allow for early and prompt diagnosis. Limits of a minimally invasive surgical rationale lie upon the effects of pneumoperitoneum induction, surgical stress, logistical resources, expertise, and costs.","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":"142 43","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Non-occlusive mesenteric ischemia in critically ill patients: does bedside laparoscopy offer any real benefit?\",\"authors\":\"Mirko Barone, Regina Frontera, Rita Vaia Liouras, Massimo Ippoliti, Luca Serano, Carmine Giovanni Iovino, I. Dell’Atti, Luigi Vetrugno, F. Mucilli, S. M. Maggiore\",\"doi\":\"10.1097/ec9.0000000000000107\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\\n Non-occlusive mesenteric ischemia in critically ill patients still has a poor prognosis. Despite several established risk factors, the interaction between clinical conditions and perfusion mismatch often leads to progressive organ failure. Workup is challenging because of the absence of typical abdominal signs and symptoms due to sedation, poor reactivity, need for ventilation, and confounding comorbidities. Moreover, imaging has poor specificity with findings often inconclusive. A bedside exploratory laparoscopy, as a complementary strategy, would allow for early and prompt diagnosis. Limits of a minimally invasive surgical rationale lie upon the effects of pneumoperitoneum induction, surgical stress, logistical resources, expertise, and costs.\",\"PeriodicalId\":72895,\"journal\":{\"name\":\"Emergency and critical care medicine\",\"volume\":\"142 43\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Emergency and critical care medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/ec9.0000000000000107\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Emergency and critical care medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/ec9.0000000000000107","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Non-occlusive mesenteric ischemia in critically ill patients: does bedside laparoscopy offer any real benefit?
Non-occlusive mesenteric ischemia in critically ill patients still has a poor prognosis. Despite several established risk factors, the interaction between clinical conditions and perfusion mismatch often leads to progressive organ failure. Workup is challenging because of the absence of typical abdominal signs and symptoms due to sedation, poor reactivity, need for ventilation, and confounding comorbidities. Moreover, imaging has poor specificity with findings often inconclusive. A bedside exploratory laparoscopy, as a complementary strategy, would allow for early and prompt diagnosis. Limits of a minimally invasive surgical rationale lie upon the effects of pneumoperitoneum induction, surgical stress, logistical resources, expertise, and costs.