Jana SmalcovaGeneral University Hospital; First Medical Faculty Charles University, Czech Republic
Title: Non-occlusive mesenteric ischemia in cardiac arrest
Non-Occlusive Mesenteric Ischemia (NOMI) belongs to the serious and probably underestimated complications in critically ill patients, including cardiac arrest (CA) patients. Given the susceptibility of enterocytes to ischemia, the incidence and severity of NOMI in the post-resuscitation period may reflect the intensity and duration of both ischemia and subsequent reperfusion injury. The diagnosis is complicated; the treatment and diagnostics options are limited.
NOMI is considered to be associated with adverse neurological outcomes in CA patients. Therefore, NOMI should not only be regarded as a post-resuscitation complication but also as one of the prognostic markers in CA patients. According to the Prague OHCA study, the occurrence of clinical manifestations of intestinal ischemia-reperfusion injury in patients with refractory CA treated with Extracorporeal Cardiopulmonary Resuscitation (ECPR) was significantly associated with adverse neurological outcomes (CPC 3-5) at day 180.
This presentation summarizes current knowledge on NOMI's pathophysiology, diagnosis, treatment, and prognostic significance in CA patients.
Jana Smalcova is a cardiologist and intensivist at the General University Hospital and First Faculty of Medicine, Charles University in Prague, Czech Republic. Her main interests are patients with refractory cardiac arrest, ECPR and post-resuscitation syndrome. She is the author and co-author of more than 15 cardiac arrest and ECPR publication.