Acute mesenteric ischaemia : Part II

A soon as diagnosis of AMI is established or suspected, fluid resuscitation should be begun immediately with isotonic crystalloids, blood and blood products as deemed necessary. Electrolyte imbalances such as hyperkalemia, acidosis and other metabolic abnormalities should be corrected. Invasive arterial and central venous pressure monitoring along with monitoring of urine output are recommended to ensure adequate optimization prior to intervention. Broad-spectrum antibiotics are given to minimize the consequences of bacterial translocation and systemic sepsis. Intravenous heparin should be administered unless there is a specific contraindication. Fluid resuscitation should be adjusted until adequate right-sided filling pressures are achieved. Vasopressors may be needed to maintain systemic blood pressure at physiological levels(>100 mm Hg); however, this should not substituted for inadequate volume resuscitation.