医学
肠系膜缺血
休克(循环)
血管收缩
循环系统
心脏病学
心源性休克
血流动力学
肠系膜动脉
感染性休克
缺血
麻醉
内科学
败血症
动脉
心肌梗塞
作者
Eugene P. Ceppa,Katherine C. Fuh,Gregory B. Bulkley
出处
期刊:Current Opinion in Critical Care
[Ovid Technologies (Wolters Kluwer)]
日期:2003-04-01
卷期号:9 (2): 127-132
被引量:128
标识
DOI:10.1097/00075198-200304000-00008
摘要
The mesenteric hemodynamic response to circulatory shock is substantial and asymmetrical; the vasoconstrictive response disproportionately affects the mesenteric organs. The cardiac output is sustained partially, at no cost in nutrient flow to the mesenteric organs, by vasoconstriction of the mesenteric veins, resulting in the "autotransfusion" of up to 30% of the circulating blood volume into the systemic circulation.Hemorrhagic or cardiogenic shock also results in decreased perfusion pressure, prompting selective vasoconstriction of the mesenteric arterioles to maintain perfusion pressure of the vital organs, here at the selective expense of the mesenteric organs. Septic shock may be associated with increased or decreased mesenteric blood flow but is characterized by increased oxygen consumption, exceeding the capability of mesenteric oxygen delivery.The response to any of these conditions can, variably and unpredictably, cause hemorrhagic gastric stress erosions, nonocclusive mesenteric ischemia of the small bowel, ischemic colitis, ischemic hepatitis, acalculous cholecystitis, and/or ischemic pancreatitis. Injury to the mesenteric organs can also initiate the systemic inflammatory response syndrome and, consequently, multiple organ failure.
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