Document Detail


Pneumatosis intestinalis and hepatic portal venous gas after CPR.
MedLine Citation:
PMID:  15765340     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pneumatosis intestinalis and hepatic portal venous gas are usually associated with severe intra-abdominal pathologies. As diagnostic technologies advanced, a number of variant etiologies have been identified. We report 2 cases in which pneumatosis intestinalis and hepatic portal venous gas developed after prolonged cardiopulmonary resuscitation (CPR). The pathogenic mechanism was most probably bowel infarction caused by poor mesenteric perfusion during and after CPR. Limited cardiac output during prolonged resuscitation and severe vasoconstriction after large doses of epinephrine and vasopressors might both contribute to the compromised mesenteric perfusion. The risk seems especially high for old patients with severe atherosclerosis. Once it happens, the prognosis is extremely poor. In patients of cardiac arrests receiving prolonged CPR, catastrophic complications like this should be considered in the postresuscitation phase, especially those with multiple risk factors like old age, severe atherosclerosis, and use of large doses of vasoconstrictors.
Authors:
Chun-Fu Lai; Wei-Tien Chang; Po-Chin Liang; Wan-Ching Lien; Hsiu-Po Wang; Wen-Jone Chen
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  23     ISSN:  0735-6757     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-14     Completed Date:  2005-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  177-81     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation / adverse effects*
Electric Countershock
Embolism, Air / diagnosis,  etiology
Emergency Medicine / methods*
Fatal Outcome
Heart Arrest / therapy
Humans
Male
Middle Aged
Pneumatosis Cystoides Intestinalis / diagnosis*,  etiology*
Portal Vein*
Shock / complications,  therapy
Ventricular Fibrillation / etiology,  therapy

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


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