Bowel ischemia following extracorporeal cardiopulmonary resuscitation (ECPR): case reports and narrative review.
6 affiliations
- 1Department of Critical Care Medicine, Chang-an Hospital of Dongguan, Chang-an Hospital Affiliating to the First Affiliated Hospital of Jinan University, Dongguan City, Guangdong Province, China. [email protected].
- 2Department of Extracorporeal Circulation, Heart Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou City, Guangdong Province, China.
- 3Key Laboratory on Assisted Circulation, Ministry of Health, Guangzhou City, Guangdong Province, China.
- 4Department of Intensive Care Medicine, Binhaiwan Central Hospital of Dongguan, Dongguan City, Guangdong Province, China.
- 5The Key Laboratory for Prevention and Treatment of Critical Illness, Dongguan City, Guangdong Province, China.
- 6Department of Critical Care Medicine, Chang-an Hospital of Dongguan, Chang-an Hospital Affiliating to the First Affiliated Hospital of Jinan University, Dongguan City, Guangdong Province, China.
Abstract
Background
Extracorporeal cardiopulmonary resuscitation (ECPR) is a life-saving strategy for refractory cardiac arrest (CA), but the mortality rate is still high. Bowel ischemia is associated with the clinical outcomes, and few studies on bowel ischemia following ECPR have been reported.Methods
We reported 2 cases of bowel ischemia following ECPR. And we searched literature to describe the incidence, clinical features, and outcomes of bowel ischemia following ECPR. Demographic features, risk factors, clinical features, diagnostic methods, treatment and outcome were analyzed.Results
We described 2 patients developed bowel ischemia with recurred hematochezia at different phases post ECPR, conservative treatments were not effective, one patient received colectomy after extracorporeal membrane oxygenation (ECMO) weaning and recovered, and the other died without surgery. Our literature search found 3 publications. Non-occlusive mesenteric ischemia(NOMI) was more common for bowel ischemia following ECPR, and the incidence of NOMI in ECPR patients seemed higher than that in conventional CPR patients. Postmortem findings demonstrated signs of bowel ischemia within hours of ECPR. The incidence of bowel ischemia following ECPR could not be identified due to the variability among the studies.Conclusion
Bowel ischemia may initiate early post ECPR, or occur insidiously during the therapeutic process, thus clinicians should have a high suspicion and low threshold for CT scan and endoscopy. Surgical timing for advanced bowel ischemia should be individualized.
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BibTeX
@article{chen2026bowel,
title = {{Bowel ischemia following extracorporeal cardiopulmonary resuscitation (ECPR): case reports and narrative review.}},
author = {Yanzhu Chen and Shaoyan Mo and Minghan Deng and Hanwen He},
journal = {International journal of emergency medicine},
year = {2026},
month = jul,
doi = {10.1186/s12245-026-01327-6},
url = {https://europepmc.org/article/MED/42928120},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Bowel ischemia following extracorporeal cardiopulmonary resuscitation (ECPR): case reports and narrative review.
AU - Yanzhu Chen
AU - Shaoyan Mo
AU - Minghan Deng
AU - Hanwen He
PY - 2026
DA - 2026/07/28
JO - International journal of emergency medicine
DO - 10.1186/s12245-026-01327-6
UR - https://europepmc.org/article/MED/42928120
AB - Background Extracorporeal cardiopulmonary resuscitation (ECPR) is a life-saving strategy for refractory cardiac arrest (CA), but the mortality rate is still high. Bowel ischemia is associated with the clinical outcomes, and few studies on bowel ischemia following ECPR have been reported.Methods We reported 2 cases of bowel ischemia following ECPR. And we searched literature to describe the incidence, clinical features, and outcomes of bowel ischemia following ECPR. Demographic features, risk factors, clinical features, diagnostic methods, treatment and outcome were analyzed.Results We described 2 patients developed bowel ischemia with recurred hematochezia at different phases post ECPR, conservative treatments were not effective, one patient received colectomy after extracorporeal membrane oxygenation (ECMO) weaning and recovered, and the other died without surgery. Our literature search found 3 publications. Non-occlusive mesenteric ischemia(NOMI) was more common for bowel ischemia following ECPR, and the incidence of NOMI in ECPR patients seemed higher than that in conventional CPR patients. Postmortem findings demonstrated signs of bowel ischemia within hours of ECPR. The incidence of bowel ischemia following ECPR could not be identified due to the variability among the studies.Conclusion Bowel ischemia may initiate early post ECPR, or occur insidiously during the therapeutic process, thus clinicians should have a high suspicion and low threshold for CT scan and endoscopy. Surgical timing for advanced bowel ischemia should be individualized.
SN - 1865-1372
SN - 1865-1380
ER -