1. Bronchoscopy is associated with decreased mesenteric arterial flow
- Author
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Lülüfer Tamer, Suzan Bayindir, Candan Öztürk, Sibel Atis, Meltem Nass Duce, and Ali Nayci
- Subjects
Adult ,Male ,medicine.medical_specialty ,Ischemia ,Hemodynamics ,Bacteremia ,Critical Care and Intensive Care Medicine ,Gastroenterology ,Hospitals, University ,Bronchoscopy ,Mesenteric Artery, Superior ,medicine.artery ,Intensive care ,Internal medicine ,Gram-Negative Bacteria ,medicine ,Fiber Optic Technology ,Humans ,Superior mesenteric artery ,Splanchnic Circulation ,Aged ,medicine.diagnostic_test ,business.industry ,Blood flow ,Middle Aged ,medicine.disease ,Oxidative Stress ,Mesenteric ischemia ,Anesthesia ,Bacterial Translocation ,Reperfusion Injury ,Arterial blood ,Female ,business ,Biomarkers - Abstract
Background: We hypothesized that fiberoptic bronchoscopy can contribute to mesenteric ischemia and bacterial translocation. Objective: To test this hypothesis we investigated in patients undergoing bronchoscopy mesenteric blood flow and markers in association with ischemia reperfusion injury. Patient: Forty-seven consecutive patients requiring diagnostic fiberoptic bronchoscopy were studied. Measurements: Parameters evaluated were superior mesenteric artery Doppler sonography, oxidative stress mediators, arterial blood gases, blood cultures pre-fiberoptic bronchoscopy, and 1st, 4th, and 24th hr post-fiberoptic bronchoscopy. Main Results: After bronchoscopy; Pao 2 decreased by 21.8% ± 1.5% (range 6-40), and remained low at all time points (p = 0.0001, p = 0.0001, p = 0.008). Flow volume decreased by 38.8% ± 14.9% (range 6-72), and remained low at 1st and 4th hr (p = 0.0001, p = 0.01). Resistive and pulsatile index increased at 1st hr (p = 0.0001, p = 0.001) and 4th hr (p = 0.018, p = 0.045). Myeloperoxidase and malondialdehyde increased at 1st hr (p = 0.0001) and 4th hr (p = 0.037, p = 0.028). Corresponding glutathione and catalase decreased at 1st hr (p = 0.0001), and glutathione remained significant at 4th and 24th hr (p = 0.0001, p = 0.003). Correlation between flow volume and Pao 2 (r = .71, p = 0.0001), myeloperoxidase (r = -.39, p = 0.05), glutathione (r = .41, p = 0.03) was significant. Nine of 47 (19.1%) had fever, and 3 of 47 (6.4%) had gram-negative bacteremia. Conclusion: Fiberoptic bronchoscopy is associated with decreased mesenteric blood flow, which may place the patient at risk for mesenteric ischemia and gastrointestinal bacterial translocation.
- Published
- 2008