The present study aimed to explore the protective effects of
extracorporeal membrane oxygenation (ECMO) on intestinal mucosal injury following
cardiopulmonary resuscitation (
CPR), and to assess the potential mechanisms involved. A total of 24 healthy adult domestic pigs were selected as the study subjects. A
ventricular fibrillation model was induced through programmed electric stimulation. Subsequently, the animals were randomly divided into conventional
CPR and CPR+ECMO groups (n=12 per group). The mortality and hemodynamic parameters of the two groups were compared. The expression levels of inflammatory
cytokines in the serum and intestinal mucosa were detected by ELISAs. The intestinal mucosa was subjected to
hematoxylin and
eosin, and immunohistochemical staining, followed by electron microscopy, to assess the degree of apoptosis and
necrosis. The animals in both groups recovered from the programmed
ventricular fibrillation. In the
CPR group, two animals died at 2 h and two more animals died a further 2 h later, resulting in a 33.3% mortality rate, whereas no cases of mortality were observed in the CPR+ECMO group. Compared with the animals in the
CPR group, the hemodynamic parameters of the animals in the CPR+ECMO group revealed significantly improved outcomes. Multiple inflammatory factors (
tumor necrosis factor α,
interleukin-1 and
interleukin-6),
myeloperoxidase and
malondialdehyde levels were decreased, whereas
Na/Ca-ATPase and
superoxide dismutase levels were elevated in the intestinal mucosa of animals in the CPR+ECMO group compared with those in the
CPR group. Additionally, pathological staining demonstrated that the intestinal mucosa tissue in the CPR+ECMO group exhibited less apoptosis,
necrosis and inflammatory cell infiltration, which was further supported by a decrease in Bax expression and an increase in Bcl-2 expression. Overall, ECMO after
CPR reduced the intestinal mucosal barrier injury after spontaneous circulation recovery, and the mechanism involved decreased
inflammation and apoptosis.