Non-occlusive mesenteric ischemia leading to 'pneumatosis intestinalis': a series of unfortunate hemodynamic events.

Dhoble A,
Patel K,
Khasnis A.
Department of Internal Medicine, Michigan State University, East Lansing, Michigan, USA. abhijeetdhoble@gmail.com.

ABSTRACT:
BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is not uncommon in intensive care units. NOMI indicate ischemia of bowel wall without any significant obstruction in the mesenteric arteries. Common causes of NOMI include sepsis, severe cardiac failure, and any critical illness. Mesenteric circulation can suffer due to low cardiac output leading to very unfortunate outcomes. Pneumatosis Intestinalis is a radiologic sign which represent gas in the bowel wall, and could indicate mesenteric ischemia.

CASE PRESENTATION: We present a fatal case of a patient who developed NOMI secondary to multiple factors. Patient died after a long protracted course in the hospital secondary to severe septic shock.

CONCLUSION: This case emphasizes the importance of early detection and management of NOMI in a patient with low cardiac output and abdominal pain. In majority of the studies, NOMI is associated with high morbidity and mortality.

PMID: 18657272 [PubMed - in process]

Incidence of and risk factors for transferring cancer patients from rehabilitation to acute care units.

Guo Y, Persyn L, Palmer JL, Bruera E.
Related Articles, Compound (MeSH Keyword),
Substance (MeSH Keyword), LinkOut

Am J Phys Med Rehabil. 2008 Aug;87(8):647-53. PMID: 18645323
[PubMed - indexed for MEDLINE]

Validation of Surgical Intensive Care-Infection Registry:

Validation of Surgical Intensive Care-Infection Registry: a medical informatics system for intensive care unit research, quality of care improvement, and daily patient care.

J Am Coll Surg. 2008 Aug;207(2):164-73.
Epub 2008 Jun 24. PMID: 18656042
[PubMed - indexed for MEDLINE]

In a disaster, who gets critical care? And who decides?

Potera C.
Related Articles, LinkOut

Am J Nurs. 2008 Aug;108(8):19. No abstract available. PMID: 18664746 [PubMed - indexed for MEDLINE]

Factors affecting the provision of culturally congruent care to Arab Muslims by critical care nurses

Author(s): Grech C .
ISSUE: 2008 ; VOL 21 ; PART 3 (08-2008)
Access: From Proquest NHS (02/2005 - 05/2007)
Page: 167-171 Search the Web: [article] [author(s)]

What factors influence suboptimal ward care in the acutely ill ward patient ?

Author(s): Massey D . ; Aitken L . M . ; Wendy C .
ISSUE: 2008 ; VOL 21 ; PART 3 (08-2008)
Access: From Proquest NHS (02/2005 - 05/2007)
Page: 127-140 Search the Web: [article] [author(s)]

The emerging role of the intensive care nurse practitioner

Author(s): Pirret A . M .
ISSUE: 2008 ; VOL 21 ; PART 3 (08-2008)
Access: From Proquest NHS (02/2005 - 05/2007)
Page: 125-126
Search the Web: [article] [author(s)]

Surviving sepsis campaign - The sequel

Author(s): Leslie G . D .
ISSUE: 2008 ; VOL 21 ; PART 3 (08-2008)
Access: From Proquest NHS (02/2005 - 05/2007)
Page: 123-124 Search the Web: [article] [author(s)]

Conscious sedation

Author(s):Gibb , D .
ISSUE: 2008 ; VOL 36 ; PART 4
Access: From Proquest NHS (02/1998 - 06/2007) Customer Notes: 1997 v25/1 - 2006 v34/4 Print Location: Macclesfield
Page: 616 Search the Web: [article] [author(s)]

Sedation and delirium in the intensive care unit : an Australian and New Zealand perspective

Author(s): Shehabi , Y . ; Botha , J . A . ; Boyle , M . S . ; Ernest , D . ; Freebairn , R . C . ; Jenkins , I . R . ; Roberts , B . L . ; Seppelt , I . M .
ISSUE: 2008 ; VOL 36 ; PART 4
Access: From Proquest NHS (02/1998 - 06/2007) Customer Notes: 1997 v25/1 - 2006 v34/4 Print Location: Macclesfield
Page: 570-578 Search the Web: [article] [author(s)]

Sequential Organ Failure Assessment score and comorbidity : valuable prognostic indicators in chronically critically ill patients

Author(s): Lee , K . ; Hong , S . B . ; Lim , C . M . ; Koh , Y .
ISSUE: 2008 ; VOL 36 ; PART 4
Access: From Proquest NHS (02/1998 - 06/2007) Customer Notes: 1997 v25/1 - 2006 v34/4 Print Location: Macclesfield
Page: 528-534
Search the Web: [article] [author(s)]

Health care costs, long-term survival, and quality of life following intensive care unit admission after cardiac arrest

Research Health care costs, long-term survival, and quality of life following intensive care unit admission after cardiac arrest
Graf J, Mühlhoff C, Doig G, Reinartz S, Bode K, Dujardin R, Koch K, Roeb E, Janssens UCritical Care, 2008 12:R92 ( 18 July 2008 )
[Abstract][Full text] [PDF] [PubMed]

Reliability of diagnostic coding in intensive care patients

Research
Reliability of diagnostic coding in intensive care patients
Misset B, Nakache D, Vesin A, Darmon M, Garrouste-Orgeas M, Mourvillier B, Adrie C, Pease S, de Beauregard M, Goldgran-Toledano D, Métais E, Timsit J, Critical Care, 2008 12:R95 ( 29 July 2008 )
[Abstract][Full text] [PDF] [PubMed]

Prevalence of sleep disturbances and long term reduced health-related quality of life after critical care: a prospective multicenter cohort study

Research Prevalence of sleep disturbances and long term reduced health-related quality of life after critical care: a prospective multicenter cohort study
Orwelius L, Nordlund A, Nordlund P, Edell-Gustafsson U, Sjoberg FCritical Care, 2008 12:R97 ( 1 August 2008 )
[Abstract] [Provisional PDF] [PubMed]

Combined milrinone and enteral metoprolol therapy in patients with septic myocardial depression

Research Combined milrinone and enteral metoprolol therapy in patients with septic myocardial depression
Schmittinger C, Dunser M, Haller M, Ulmer H, Luckner G, Torgersen C, Jochberger S, Hasibeder WCritical Care, 2008 12:R99 ( 4 August 2008 )
[Abstract] [Provisional PDF] [PubMed]

Fluid balance as a biomarker: impact of fluid overload on outcome in critically ill patients with acute kidney injury

Commentary Fluid balance as a biomarker: impact of fluid overload on outcome in critically ill patients with acute kidney injury
Bagshaw S, Brophy P, Cruz D, Ronco CCritical Care, 2008 12:169 ( 24 July 2008 )
[Abstract][Full text] [PDF] [PubMed]

Sepsis therapy: what's the best for the mitochondria?

Commentary Sepsis therapy: what's the best for the mitochondria?
Wagner F, Radermacher P, Georgieff M, Calzia ECritical Care, 2008 12:171 ( 6 August 2008 )
[Abstract][Full text] [PDF]

Clinical review: Liberation from mechanical ventilation

Review Clinical review: Liberation from mechanical ventilation El-Khatib M, Bou-Khalil PCritical Care, 2008 12:221 ( 6 August 2008 )
[Abstract][Full text] [PDF]