The role of nonocclusive sources of acute gut injury in cardiac surgery

摘要

MORE THAN HALF of all major gastrointestinal complications after cardiac surgery involve the bowel (Table I). While relatively uncommon (0.3%-6.1%), serious conditions involving mesenteric ischemia generally are associated with difficult postoperative courses and high mortality risk (18%-58%). Notably, recent studies provided plausible evidence that modest unappreciated nonocclu-sive acute gut injuries (AGI) also may be important (and more common) as contributors to adverse outcome after cardiac surgeiy. Here, mucosal hypoperfusion has been proposed as a unifying pathophysiologic mechanism for a wide spectrum of AGI, which extends from subtle functional abnormalities to extensive necrosis of the gut wall.