Cardiac arrest & resuscitation
The significance of possible non-occlusive mesenteric ischemia in relation to neurological outcomes in patients with refractory cardiac arrest – Secondary analysis of the Prague OHCA study
Authors' conclusion
The development of profuse diarrhea, abdominal distension and other signs suggesting non-occlusive mesenteric ischemia in patients with refractory out-of-hospital cardiac arrest are observed more frequently in patients with poor neurological outcome at day 180, especially in patients treated with ECPR.
Study context
- Population
- Patients with refractory OHCA surviving longer than 1 hour after hospital admission61 developed possible non-occlusive mesenteric ischemia (NOMI)
- Participants
- 256 patients
- Comparison
- Possible NOMI vs no possible NOMI; ECPR vs CPR
- Primary endpoint
- Neurologically unfavourable outcome (Cerebral Performance Category (CPC) 3-5) in relation to possible NOMI (clinical signs, mainly profuse diarrhoea and abdominal distension, onset within 12 h of admission)
- Follow-up
- 180 days
Methodological detailspost-hoc analysis
- Post-hoc analysis
Primary result
As reported in the abstract
Possible NOMI and adverse neurological outcome
| Group | Value | Adverse neurological outcome among those with possible NOMI |
|---|---|---|
| ECPR | 51.7% | 41 (89%) |
| CPR | 16.5% | 9 (60%) |
Value
ECPR51.7%
CPR16.5%
Adverse neurological outcome among those with possible NOMI
ECPR41 (89%)
CPR9 (60%)
- ECPR vs CPR: P > 0.01 — possible NOMI more frequent with ECPR
Further findings
Correlates of possible NOMI
- Correlated with cardiac arrest length and elevated neuron-specific enolase and procalcitonin at 48 and 72 h
Original publication
The significance of possible non-occlusive mesenteric ischemia in relation to neurological outcomes in patients with refractory cardiac arrest – Secondary analysis of the Prague OHCA study. Resuscitation. Published 15 May 2025. doi:10.
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