Incidence of Colon Ischemia in Patients After Cardiopulmonary Resuscitation (CPR)

Incidence of Colon Ischemia in Patients After Cardiopulmonary Resuscitation (CPR): a Prospective Single-center Epidemiological Incidence Study

Bedside colonoscopy 24-36 hours after successful CPR

Study Overview

• Status: Not yet recruiting
• Conditions: Cardiac Arrest (CA)
• Intervention / Treatment: Procedure: colonoscopy

Detailed Description

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
• Enrollment (Estimated): 200
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Alexander Supady, MD, MPH; Phone Number: +49-761-270-34010; Email: alexander.supady@uniklinik-freiburg.de

Study Locations

• Germany
  • Freiburg im Breisgau, Germany, 79106
    • Medical Center - University of Freiburg
    • Contact: Alexander Supady, MD, MPH; Phone Number: +49-761-270-34010; Email: alexander.supady@uniklinik-freiburg.de
    • Contact: Asieb Sekandarzad, MD; Phone Number: +49-761-270-34010; Email: asieb.sekandarzad@uniklinik-freiburg.de

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

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)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: early colonoscopy after successful CPR; bedside colonoscopy 24-36 hours after successful CPR	Procedure: colonoscopy; bedside colonoscopy without bowel cleansing early (24-36h) after successful CPR

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Detection of colon ischemia	Detection of colon ischemia within 30 days after return of spontaneous circulation	from baseline (0 hours) until day 30

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
in-hospital mortality	in-hospital mortality	from baseline (0 hours) until hospital discharge
abdominal surgery ((hemi-)colectomy)	number of patients requiring/receiving abdominal surgery ((hemi-)colectomy)	from baseline (0 hours) until hospital discharge
functional outcome	Cerebral Performance Category (CPC)	day 30, day 60 and day 90
Liver function	Liver function parameters: Quick/INR, AST, ALT, AP, g-GT	within 0-72 hours after CPR
renal function	Renal function parameters: creatinine, BUN	within 0-72 hours after CPR
Urine output	Urine output (ml)	within 0-72 hours after CPR
Renal replacement therapy	Implementation of renal replacement therapy within 30 days after return of spontaneous circulation	from baseline (day 0) until day 30
Serum lactate	Serum lactate	within 0-72 hours after CPR
SOFA score	SOFA	at 0 hours, 24 hours, 48 hours, 72 hours after CPR
SAPS II score	SAPS II	at 0 hours, 24 hours, 48 hours, 72 hours after CPR

Collaborators and Investigators

• Sponsor: University Hospital Freiburg

Study record dates

Study Major Dates

• Study Start (Estimated): January 7, 2026
• Primary Completion (Estimated): January 6, 2028
• Study Completion (Estimated): February 6, 2028

Study Registration Dates

• First Submitted: December 19, 2025
• First Submitted That Met QC Criteria: January 13, 2026
• First Posted (Actual): January 22, 2026

Study Record Updates

• Last Update Posted (Actual): January 22, 2026
• Last Update Submitted That Met QC Criteria: January 13, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: colonoscopy; CPR; cardiac arrest; cardiopulmonary resuscitation; VA ECMO; ECPR; extracorporeal cardiopulmonary resuscitation; mesenteric ischemia
• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Heart Diseases; Intestinal Diseases; Digestive System Diseases; Gastrointestinal Diseases; Peritoneal Diseases; Heart Arrest; Mesenteric Ischemia; Diagnostic Techniques and Procedures; Diagnosis; Surgical Procedures, Operative; Minimally Invasive Surgical Procedures; Diagnostic Techniques, Surgical; Endoscopy, Gastrointestinal; Endoscopy, Digestive System; Diagnostic Techniques, Digestive System; Endoscopy; Digestive System Surgical Procedures; Colonoscopy
• Other Study ID Numbers: 24-1320-S1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No