Minimal invasive intra-arterial prostaglandin therapy is currently being offered as an established and safe treatment approach for Non-occlusive mesenteric ischemia (NOMI). So far, there are no data that prospective evaluate clinical response parameters of this method and corresponding criteria for response. The investigators are therefore planning a prospective observational study on NOMI patients with the aim to collect 1. routine clinical data, 2. data from advanced angigraphic imaging and 3. data from blood biomarkers of intestinal ischemia before/at implementation of intra-arterial vasodilatory therapy. From these three data packages, the investigators hope to subsequentially derive criteria to better predict response to therapy.
Study Type
OBSERVATIONAL
Enrollment
42
Minimal invasive Cannulation of the Superior Mesenteric Artery (SMA) and subsequent intra-arterial application of prostaglandin E1 (Initial Bolus 20ug, followed by continuous Infusion of 60-80ug/24hr for 24-72hrs)
Hannover Medical School
Hanover, Lower Saxony, Germany
Improvement of ischemia
Lactate reduction \> 2mmol/l from baseline
Time frame: 24 hours following intervention
28-day mortality
key secondary outcome
Time frame: 28 days following intervention
Change of norepinephrine dose in microgram/kg/min from baseline at 24 hours
as indicator of Shock reversal
Time frame: 24 hours following intervention
simplified NOMI score, range 0-7 points with higher scores indicating more severe NOMI
angiographic characteristics of vasodilation following Initial Prostaglandin bolus
Time frame: immediately following first intra-arterial bolus
peak density (PD) as measured by 2D perfusion angiography
angiographic characteristics of vasodilation following Initial Prostaglandin bolus
Time frame: immediately following first intra-arterial bolus
area under the curve (AUC) as measured by 2D perfusion angiography
angiographic characteristics of vasodilation following Initial Prostaglandin bolus
Time frame: immediately following first intra-arterial bolus
time to peak (TTP) as measured by 2D perfusion angiography
angiographic characteristics of vasodilation following Initial Prostaglandin bolus
Time frame: immediately following first intra-arterial bolus
intestinal fatty acid-binding protein (I-FABP), smooth muscle protein of 22kDa (SM22) liver fatty acid-binding protein (L-FABP)
markers of ischemic intestinal barrier dysfunction
Time frame: 24 hours following intervention
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