The impact of mild and moderate to severe acute gastrointestinal injury on disease prognosis in ECMO-supported patients

Backgrounds: This study aims to evaluate the impact of mild and moderate-to-severe acute gastrointestinal injury (AGI) on clinical indicators and prognosis of patients undergoing extracorporeal membrane oxygenation (ECMO). Methods: From the existing case records, a retrospective analysis was conducted using the clinical data of 105 ECMO-supported patients treated at our hospital between January 2023 and October 2024. Based on AGI grades, patients were categorized into two groups: Group A (mild injury, Grade I + II, n = 55) and Group B (moderate-to-severe injury, Grade III + IV, n = 50). Both groups received ECMO support, a standardized gastrointestinal nutrition strategy, and identical treatments aimed at symptom relief. Results: Comparisons between the two groups revealed that inflammatory markers at timepoints T0–T4 were significantly lower in Group A than in Group B (p < 0.05), with less fluctuation in Group A (p > 0.05) but greater fluctuation in Group B (p < 0.05). Between T0–T4, systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were significantly higher in Group A, while central venous pressure (CVP) was lower in Group A compared to Group B (p < 0.05). Additionally, Group A exhibited smaller changes in hemodynamic indicators (p > 0.05), while Group B showed greater fluctuations (p < 0.05). Regarding outcomes, Group A had higher ECMO weaning success and discharge rates, while lower mortality compared to Group B (p < 0.05). Furthermore, complications, rehospitalization and disease recovery rate in Group A were significantly better than in Group B. Conclusions: Mild AGI (Grade I + II) has a lesser impact on inflammatory markers and hemodynamics in ECMO-supported patients and is associated with a favorable prognosis.

Acute gastrointestinal injury; Extracorporeal membrane oxygenation support; Inflammation; Mortality

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