Annals of Intensive Care volume 8 , Article number: 46 Cite this article. Metrics details. Main issue for physicians regarding bowel ischemia diagnosis lies in the absence of informative and specific clinical or biological signs leading to delayed management, resulting in a poorer prognosis, especially after cardiac surgery.
The aim of the present series was to propose a simple scoring system based on biological data for the diagnosis of bowel ischemia. In a retrospective monocentric study, patients admitted in cardiac ICU, after cardiovascular surgery, were screened for inclusion. According to a ratio caseβcontrol , matching between two groups was based on sex, type of cardiovascular surgery, and the operative period per month. Primary objective was the conception of a scoring system for the diagnosis of bowel ischemia.
Secondary objectives were to detail the postoperative morbidity and the diagnostic features for the distinction between acute mesenteric ischemia and ischemic colitis. Forty-eight patients 1. Based on their respective odds ratios, points were assigned to each item ranging from 4 to 8.
A biological scoring system based on PCT, ASAT, lactate, and myoglobin measurement allows the diagnosis of bowel ischemia after cardiac surgery with high accuracy. This score could help clinician to propose an early diagnosis and an early treatment in this high mortality disease. Gastrointestinal complications after cardiovascular surgery are rare conditions occurring in 0. Among these conditions, the most frequent one is bowel ischemia including mesenteric ischemia and ischemic colitis.
The incidence of ischemic colitis ranges from 4. From a pathophysiological point of view, bowel ischemia is associated with mucosal ulceration, inflammation, and hemorrhage, with a positive feedback due to reperfusion in case of blood flow restoration [ 7 , 8 , 9 ]. The main issue for physicians about bowel ischemia diagnosis lies in the absence of informative and specific clinical or biological signs leading to delayed management and resulting in a poorer prognosis, especially after cardiac surgery.
