{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T02:05:15Z","timestamp":1789610715418,"version":"build-2803163510"},"update-to":[{"DOI":"10.12688\/f1000research.52782.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T00:00:00Z","timestamp":1630886400000}}],"reference-count":37,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T00:00:00Z","timestamp":1630886400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    <ns3:bold>Background<\/ns3:bold>\n                    : Acute mesenteric ischaemia (AMI) is a surgical emergency which has an associated high mortality.\u00a0 The mainstay of active treatment includes early surgical intervention, with resection of non-viable bowel, and revascularisation of the ischaemic bowel where possible. Due to the physiological insult of AMI however, perioperative care often involves critical care and the use of vasoactive agents to optimise end organ perfusion. A number of these vasoactive agents are currently available with varied mechanism of action and effects on splanchnic blood flow. However, specific guidance on which is the optimal vasoactive drug to use in these settings is limited. This systematic review aimed to evaluate the current evidence comparing vasoactive drugs in AMI.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Methods<\/ns3:bold>\n                    : A systematic search of Ovid Medline, Ovid Embase, Cochrane CENTRAL and the Cochrane Database of Systematic Review was performed on the 5th of November 2020 to identify randomised clinical trials comparing different vasoactive agents in AMI on outcomes including mortality. The search was performed through the Royal College of Surgeons of England (RCSEng) search support library. Results were analysed using the Rayyan platform, and independently screened by four investigators.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Results<\/ns3:bold>\n                    :\u00a0614 distinct papers were identified. After screening, there were no randomised clinical trials meeting the inclusion criteria.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Conclusions<\/ns3:bold>\n                    : This review identifies a gap in literature, and therefore recommends an investigation into current practice and clinician preference in relation to vasoactive agents in AMI. Multicentre randomised controlled trials comparing these medications on clinical outcomes will therefore be required to address this question.\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.52782.2","type":"journal-article","created":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T09:40:07Z","timestamp":1630921207000},"page":"453","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Vasoactive agents in acute mesenteric ischaemia in critical care.\u00a0 A systematic\u00a0review"],"prefix":"10.12688","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6630-2170","authenticated-orcid":false,"given":"Christopher A","family":"Brennan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Osei-Bonsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael Eimear","family":"McClenaghan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Nassar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Forget","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6904-7048","authenticated-orcid":false,"given":"Callum","family":"Kaye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9862-2323","authenticated-orcid":false,"given":"George","family":"Ramsay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2021,9,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"253-270","DOI":"10.1007\/s00068-016-0634-0","article-title":"ESTES 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perfusion in hypoxia-reoxygenated newborn piglets treated with dopamine.","volume":"71","author":"N Manouchehri","year":"2012","journal-title":"Pediatr Res."},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.7910\/DVN\/2GN0BS","article-title":"Review Data for: Vasoactive agents in acute mesenteric ischaemia in critical care. A systematic review","volume":"V1","author":"C Brennan","year":"2021","journal-title":"Harvard Dataverse."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/10-453\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/10-453\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/10-453\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T05:15:33Z","timestamp":1632287733000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/10-453\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,6]]},"references-count":37,"URL":"https:\/\/doi.org\/10.12688\/f1000research.52782.2","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.58870.r93548","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.58870.r93548","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,6]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/10-453\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.56103.r87014, Nick Heywood, East Lancashire Hospitals NHS Trust, East Lancashire, UK, 14 Jun 2021, version 1, 3 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/10-453\/v1#referee-response-87014","order":0,"name":"referee-response-87014","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Christopher Brennan<\/b>; \n<i>Posted: 24 Aug 2021<\/i>;  \n<i>The authors state that their aim in the introduction is: \u201cThis primary aim of this systematic review is to evaluate the current evidence comparing mortality outcomes for vasoactive drugs in AMI\u201d,&nbsp;however in the results section they state that&nbsp;\u201cThis systematic review aimed to identify randomised control trials comparing mortality rates in relation to the use of different vasoactive drugs in AMI.\u201d&nbsp;The authors state in the abstract results section that there is no randomised controlled trial, and this is the only result. The authors included non-randomised trials including case reports in their search, yet there is no comment on the results, nor any narrative as to the types of study out of the 614 returned in the search. There should be a descriptive in the result section as to the numbers of each types of study, i.e. number of case reports (including number of patients in these case reports), number of observational studies etc. Our primary interest in undertaking this work was to assess whether there was capacity for a randomised clinical trial to be developed comparing different vasoactive agents in this field. Thus, for this systematic review only RCT\u2019s were considered for inclusion.<\/i> \n<b>Response: <\/b>The search protocol identified many non-RCT\u2019s, which were excluded at an early stage and not further analysed. The further RCT\u2019s were excluded for being entirely unrelated, or trials not performed in humans.&nbsp;We have edited the results section to clarify this. We have also added a descriptor in the results section highlighting the breakdown of results, and reasons for exclusion. &nbsp; \n<i>The Methods section is very detailed and could be easily replicated. I commend the authors for their thorough search of the all the relevant articles.<\/i> \n<b>Response: <\/b>We thank the reviewer for their commendation. &nbsp; \n<i>With regards to the findings, they do indeed make this study difficult to write in a manuscript and the authors need to be clear about searching for rCTs vs case inclusion of case reports. For example, if the authors were not interested in case reports, why were they not excluded early in the study. It may be that they wanted to ensure no studies were missed, but this should be discussed in the paper. Case reports were identified in the initial search protocol and thus acknowledged. However as we were specifically interested in RCT\u2019s, these were excluded.<\/i> \n<b>Response:<\/b> As the reviewer suggests, we did not want to miss any studies and this is why we did not remove case reports initially. This fact has been further highlighted in the methods section. &nbsp; \n<i>The findings, or lack thereof, makes the discussion limited. Upon reading the discussion, it felt like reading a review article rather than the discussion section of a systematic review. I understand that the authors need to write the discussion, but much of this does not seem relevant to the discussion section of this type of article. It feels more at place in an introduction or a separate article regarding the choices of treatments for this disease process.<\/i> \n<b>Response:<\/b> Given the results of our systematic review we felt that discussion around the broader topic would be of benefit to provide context to the relevance of our review. Due to the review only specifically looking for RCT\u2019s, further analysis of the case reports identified was not performed. This is an area of research that, with our search strategy freely available, could be performed in the future. We have added this statement to the conclusion section. &nbsp; \n<i>The authors should focus on discussing the types of papers that were found in the review, what types of studies they found and their limitations. The should also discuss why some of the 29 non-relevant RCTs were indeed non-relevant. Although the authors touch upon this in the introduction, they may wish to focus the discussion on the difficulties associated with undertaking this type of study and why there may be lack of data. A degree of speculation is needed here, but would be more relevant than the pharmacology of vasoactive drugs, for which should not really be included in the discussion section.<\/i> \n<b>Response: <\/b>Of the 29 human non-relevant RCT\u2019s, none were on the subject of mesenteric ischaemia, or vasoactive support. We have specifically clarified this point in the discussion section.","URL":"https:\/\/f1000research.com\/articles\/10-453\/v2#referee-comment-7075","order":1,"name":"referee-comment-7075","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.58870.r93548, Norman Galbraith, University Department of Surgery, Glasgow Royal Infirmary, Glasgow, UK, 22 Sep 2021, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/10-453\/v2#referee-response-93548","order":2,"name":"referee-response-93548","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.56103.r87010, Xavier Wittebole, Department of Critical Care Medicine, Clinique Universitaire St Luc, Universit\u00e9 Catholique de Louvain, Brussels, Belgium, 29 Jun 2021, version 1, 3 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/10-453\/v1#referee-response-87010","order":3,"name":"referee-response-87010","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}