Document Detail


Bronchoscopy is associated with decreased mesenteric arterial flow.
MedLine Citation:
PMID:  18679123     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We hypothesized that fiberoptic bronchoscopy can contribute to mesenteric ischemia and bacterial translocation. OBJECTIVE: To test this hypothesis we investigated in patients undergoing bronchoscopy mesenteric blood flow and markers in association with ischemia reperfusion injury. PATIENT: Forty-seven consecutive patients requiring diagnostic fiberoptic bronchoscopy were studied. MEASUREMENTS: Parameters evaluated were superior mesenteric artery Doppler sonography, oxidative stress mediators, arterial blood gases, blood cultures pre-fiberoptic bronchoscopy, and 1st, 4th, and 24th hr post-fiberoptic bronchoscopy. MAIN RESULTS: After bronchoscopy; PaO2 decreased by 21.8% +/- 1.5% (range 6-40), and remained low at all time points (p = 0.0001, p = 0.0001, p = 0.008). Flow volume decreased by 38.8% +/- 14.9% (range 6-72), and remained low at 1st and 4th hr (p = 0.0001, p = 0.01). Resistive and pulsatile index increased at 1st hr (p = 0.0001, p = 0.001) and 4th hr (p = 0.018, p = 0.045). Myeloperoxidase and malondialdehyde increased at 1st hr (p = 0.0001) and 4th hr (p = 0.037, p = 0.028). Corresponding glutathione and catalase decreased at 1st hr (p = 0.0001), and glutathione remained significant at 4th and 24th hr (p = 0.0001, p = 0.003). Correlation between flow volume and PaO2 (r = .71, p = 0.0001), myeloperoxidase (r = -.39, p = 0.05), glutathione (r = .41, p = 0.03) was significant. Nine of 47 (19.1%) had fever, and 3 of 47 (6.4%) had gram-negative bacteremia. CONCLUSION: Fiberoptic bronchoscopy is associated with decreased mesenteric blood flow, which may place the patient at risk for mesenteric ischemia and gastrointestinal bacterial translocation.
Authors:
Ali Nayci; Sibel Atis; Meltem Nass Duce; Suzan Bayindir; Lulufer Tamer; Candan Ozturk
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  36     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-27     Completed Date:  2008-10-02     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2517-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatric Surgery, Mersin University School of Medicine, Mersin Turkey. anayci@mersin.edu.tr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bacteremia / etiology
Bacterial Translocation
Biological Markers / blood
Bronchoscopy / adverse effects*
Female
Fiber Optic Technology
Gram-Negative Bacteria / physiology
Hospitals, University
Humans
Male
Mesenteric Artery, Superior / physiopathology*
Middle Aged
Oxidative Stress
Reperfusion Injury / etiology*,  physiopathology
Splanchnic Circulation
Chemical
Reg. No./Substance:
0/Biological Markers
Comments/Corrections
Comment In:
Crit Care Med. 2008 Sep;36(9):2680-1   [PMID:  18728478 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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