Document Detail

Protection of the small intestine from nonocclusive mesenteric ischemic injury due to cardiogenic shock.
MedLine Citation:
PMID:  3799886     Owner:  NLM     Status:  MEDLINE    
In a pericardial tamponade model of cardiogenic shock in pigs, we had previously shown that acute reductions in cardiac output produce severe mesenteric ischemia due to disproportionate splanchnic vasoconstriction. In this study, we extended the period of cardiogenic shock in order to investigate the pathogenesis of ischemic injury to the small intestinal wall. Four hours of tamponade produced sustained changes in splanchnic hemodynamics, similar to those observed in the prior short-term experiments. The resultant mesenteric ischemia caused necrotic lesions of the small intestine which were characteristic of those seen in nonocclusive mesenteric ischemia in human subjects. Prior alpha-adrenergic blockade failed to prevent either sustained mesenteric vasospasm or ischemic injury. In contrast, prior blockade of the renin-angiotensin axis, whether by nephrectomy or angiotensin-converting enzyme inhibition, blocked the splanchnic vasoconstriction, and thereby protected the small intestine from ischemic injury. The primary hemodynamic and pathologic features of this model of nonocclusive mesenteric ischemia appear to be mediated by the renin-angiotensin axis.
R W Bailey; G B Bulkley; S R Hamilton; J B Morris; U H Haglund
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of surgery     Volume:  153     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1987 Jan 
Date Detail:
Created Date:  1987-02-19     Completed Date:  1987-02-19     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  108-16     Citation Subset:  AIM; IM    
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MeSH Terms
Cardiac Output
Cardiac Tamponade / complications*
Intestinal Mucosa / pathology*
Intestine, Small / blood supply*
Ischemia / etiology*,  pathology,  prevention & control
Phenoxybenzamine / pharmacology,  therapeutic use
Renin-Angiotensin System / drug effects
Grant Support
Reg. No./Substance:

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