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K Glenister

Publications and source records attributed to K Glenister.

2 recordsLinked to original sources
PubMed2001

Monitoring intestinal ischaemia.

OBJECTIVE: To review the clinical and experimental methods of detecting intestinal ischaemia and to assess their value in current clinical practice. DATA SOURCES: Relevant articles and published reviews on intestinal ischaemia and/or infarction. SUMMARY OF REVIEW: The incidence of acute mesenteric ischaemia has increased substantially over the last few decades. Death rates of 70% to 90% have been reported for this condition. Improved management depends upon prompt diagnosis and early aggressive management. Despite mounting evidence that ischaemic intestinal injury may be frequent and may be a cause of multi-organ failure, accurate monitor-ing of the intestinal circulation in critically ill patients continues to be a distant goal. The need for a reliable, specific test of intestinal ischaemia has been recognised for many years. Numerous potential monitors have been evaluated including intraluminal pCO2, abdominal CT, abdominal MRI and specific plasma enzymes, but few have shown potential to be clinically useful. At present no specific test for intestinal ischaemia and/or infarction is in routine clinical use. Development of a specific test to monitor for intestinal injury would be of great clinical value. Further work will inevitably lead to the development of useful markers. CONCLUSIONS: Accurate detection of intestinal ischaemia in the critically ill patient is often difficult. While numerous tests have been examined to diagnose and monitor intestinal ischaemia and/or infarction most exhibit an unacceptably low specificity and sensitivity.

Journal Article↗
PubMed2001

Circulating secretory phospholipase A2 in critical illness--the importance of the intestine.

OBJECTIVE: To review the role of secretory phospholipase A2 in the pathogenesis of multiple organ failure in the critically ill patient. DATA SOURCES: Relevant articles and published reviews on secretory phospholipase A2 in critical illness. SUMMARY OF REVIEW: Secretory phospholipase A2 (sPLA2) has an important role in inflammation and in antimicrobial defence. However, excessive activity of sPLA2 has been shown to result in tissue damage and has been implicated as a mediator of organ failure associated with critical illness. Gastrointestinal release of secretory phospholipase A2 from Paneth cells increases during intestinal ischaemia and may be an important factor in the pathogenesis of the multiple organ dysfunction syndrome. In experimental models, specific PLA2 inhibitors reduce organ failure associated with sPLA infusion and may play an important role in reducing organ failure in the management of the critically ill patient. CONCLUSIONS: Intestinal ischaemia may play an important role in the pathogenesis of the multiple organ dysfunction syndrome in the critically ill patient. In patients with sepsis, specific PLA2 inhibitors have the potential to reduce organ failure and improve morbidity and mortality.

Journal Article↗