Langenbeck's Archives of Surgery

, Volume 396, Issue 1, pp 13–29 | Cite as

Intestinal ischemia/reperfusion: microcirculatory pathology and functional consequences

Review Article

Abstract

Background

Intestinal ischemia and reperfusion (I/R) is a challenging and life-threatening clinical problem with diverse causes. The delay in diagnosis and treatment contributes to the continued high in-hospital mortality rate.

Results

Experimental research during the last decades could demonstrate that microcirculatory dysfunctions are determinants for the manifestation and propagation of intestinal I/R injury. Key features are nutritive perfusion failure, inflammatory cell response, mediator surge and breakdown of the epithelial barrier function with bacterial translocation, and development of a systemic inflammatory response. This review provides novel insight into the basic mechanisms of damaged intestinal microcirculation and covers therapeutic targets to attenuate intestinal I/R injury.

Conclusion

The opportunity now exists to apply this insight into the translation of experimental data to clinical trial-based research. Understanding the basic events triggered by intestinal I/R may offer new diagnostic and therapeutic options in order to achieve improved outcome of patients with intestinal I/R injury.

Keywords

Perfusion failure Local inflammation Bacterial translocation Conditioning maneuvers enteral nutrients 

Notes

Conflicts of interest

None.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Institute for Experimental SurgeryUniversity of RostockRostockGermany
  2. 2.Institute for Clinical and Experimental SurgeryUniversity of SaarlandHomburg-SaarGermany

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