Bedside colonoscopy 24-36 hours after successful CPR
According to previous observations, many patients after CPR develop acute non-occlusive mesenteric ischemia. However, due to the lack of established screening strategies, the number of unreported cases may be high. Routine colonoscopy at 24-36 hours after CPR may be a safe, easy and cost-effective strategy for early detection of severe mesenteric ischemia and transfer to surgical treatment. However, this strategy has not been formally evaluated in larger prospective cohorts. In our center, we perform routine colonoscopy at 24 to 36 hours after cardiac arrest in all patients who receive extracorporeal CPR (ECPR), i.e., in all patients with prolonged cardiac arrest refractory to conventional CPR measures who therefore receive venoarterial extracorporeal membrane oxygenation (VA ECMO) for cardiocirculatory support. In these patients, colonoscopy screening was feasible and safe, and our data suggest clinical benefit.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
200
bedside colonoscopy without bowel cleansing early (24-36h) after successful CPR
Medical Center - University of Freiburg
Freiburg im Breisgau, Germany
Detection of colon ischemia
Detection of colon ischemia within 30 days after return of spontaneous circulation
Time frame: from baseline (0 hours) until day 30
in-hospital mortality
in-hospital mortality
Time frame: from baseline (0 hours) until hospital discharge
abdominal surgery ((hemi-)colectomy)
number of patients requiring/receiving abdominal surgery ((hemi-)colectomy)
Time frame: from baseline (0 hours) until hospital discharge
functional outcome
Cerebral Performance Category (CPC)
Time frame: day 30, day 60 and day 90
Liver function
Liver function parameters: Quick/INR, AST, ALT, AP, g-GT
Time frame: within 0-72 hours after CPR
renal function
Renal function parameters: creatinine, BUN
Time frame: within 0-72 hours after CPR
Urine output
Urine output (ml)
Time frame: within 0-72 hours after CPR
Renal replacement therapy
Implementation of renal replacement therapy within 30 days after return of spontaneous circulation
Time frame: from baseline (day 0) until day 30
Serum lactate
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Serum lactate
Time frame: within 0-72 hours after CPR
SOFA score
SOFA
Time frame: at 0 hours, 24 hours, 48 hours, 72 hours after CPR
SAPS II score
SAPS II
Time frame: at 0 hours, 24 hours, 48 hours, 72 hours after CPR