Pulmonary Physiologic Assessment of Patients on Veno-arterial Extracorporeal Membrane Oxygenation (VA ECMO)
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 试验地点
- 1
- 主要终点
- Percent of total distribution of ventilation by region, on given ventilator settings
研究概览
简要总结
There is limited data on the respiratory system mechanics and ideal mode of ventilation for patients on veno-arterial extra-corporeal membrane oxygenation (VA ECMO) post cardiac arrest. In this observational study, the investigators will review and/or obtain laboratory, hemodynamic, respiratory system mechanical, and clinical data from patients on VA ECMO. The specific aims of this study are as follows:
Aim 1: To characterize the lung ventilation strategy employed in patients on VA ECMO and its success.
Aim 2: To characterize respiratory system mechanics while on ECMO using esophageal manometry and Electrical Impedance Tomography (EIT).
Aim 3: To characterize right heart function and pulmonary vascular hemodynamics on the employed ventilation strategy.
The overarching hypothesis is that fine-tuned individualized ventilation might be superior to an algorithm that does not account for cardiac and pulmonary functions. Therefore, the aims of this study are to identify areas in which the ventilation strategy may theoretically be suboptimal, which will guide future interventional studies investigating alternatives methods of ventilation which may reduce time on the ventilator after cardiac arrest, time in the intensive care unit, and need for veno-venous ECMO.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •On VA ECMO after cardiac arrest
- •Between 18 and 85 years of age
- •Has an orogastric or nasogastric tube with esophageal balloon capabilities in place
排除标准
- •Known pre-existing significant pulmonary pathology
- •Pacemaker or implanted cardiac defibrillator
结局指标
主要结局
Percent of total distribution of ventilation by region, on given ventilator settings
时间窗: Within 24-48 hours of ECMO cannulation
EIT will be used to determine the percent of total ventilation occurring in each of four lung quadrants on an axial plane: right upper, left upper, right lower, and left lower.
次要结局
- Time on VA-ECMO(14 days, 90 days)
- 90-day mortality(90 days)
- Time on mechanical ventilation(14 days, 90 days)
- Need to transition to VV-ECMO(14 days, 90 days)
- Time in ICU(14 days, 90 days)
- Incidence of ventilator-associated pneumonia(14 days, 90 days)
研究者
Lorenzo Berra, MD
Reginald Jenney Associate Professor of Anaesthesia
Massachusetts General Hospital