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.

Inclusion Criteria:

• adult patients (≥ 18 years) admitted to the participating department AND
• in-hospital or out-of-hospital cardiac arrest (IHCA, OHCA)

Exclusion Criteria:

• resuscitation period of ≤ 5 minutes
• awake and contactable patients (GCS ≥ 13)