Efficacy and Safety of Synchronized Cardiac Support in Cardiogenic Shock Patients

Not Applicable

Not yet recruiting

• Conditions: Cardiogenic Shock; Extracorporeal Membrane Oxygenation; ECLS; VA ECMO
• Interventions: Device: Synchronized Cardiac Support with the icor kit

• Registration Number: NCT05106491
• Lead Sponsor: Xenios AG

Brief Summary

The study aims to investigate the safety and efficacy of the Synchronized Cardiac Support treatment wit the icor kit and the Xenios console with modified sensor box ECG and Software Version 3.2.4

Detailed Description

The current study hypothesizes that The SCS treatment with the icor kit provides sufficient support for cardiocirculatory function as indicated by a significant lactate reduction 24 hours on SCS treatment versus before treatment start.

Patients with cardiogenic shock, requiring a venoarterial extracorporeal membrane oxygenation (VA ECMO) for cardiocirculatory stabilization will be treated with Synchronized Cardiac Support.

Synchronized Cardiac Support describes an electrocardiogram (ECG)- triggered pulsatile VA-ECMO based on R-wave detection. During diastole the pump speed and thus the flow is increased and during systole the pump flow is been set on a relative minimum. This provides a mechanical circulatory support pulse with oxygenated blood during diastole.

The Synchronized Cardiac Support Treatment is used in a standard VA ECMO configuration by two femoral single vessel cannulas. Patients following cardiac resuscitation will undergo targeted temperature management 32- 36°C according to guideline.

The Duration of Treatment can be up to 14 days.

Study Timeline

• Study First Submitted: 2021-10-05
• Study First Submitted QC: 2021-10-22
• Study First Posted: 2021-11-03
• Status Verified: 2024-02
• Last Update Submitted: 2024-02-28
• Last Update Posted: 2024-02-29
• Study Start: 2024-09
• Primary Completion: 2025-09
• Study Completion: 2025-09

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 21

Inclusion Criteria

1. Informed consent signed and dated by study patient/legal representative and investigator/authorised physician

2. Minimum age of 18 years

3. Patients in cardiogenic shock

4. Cardiogenic shock is defined as:

   1. Systolic blood pressure < 90 mmHg for at least 30 min
   2. Inotropes and/or vasopressors are needed to maintain systolic blood pressure > 90 mmHg
   3. Clinical signs of heart insufficiency with pulmonary congestion

5. Signs of end organ hypoperfusion with at least one of the following criteria:

   1. Cold, damp skin or extremities
   2. Oliguria (≤ 30 mL/h)

6. Serum lactate > 3.0 mmol/L

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Exclusion Criteria

1. In case of female patients: pregnancy or lactation period
2. Participation in an interventional clinical study during the preceding 30 days
3. Previous participation in the same study
4. Age > 85 years
5. Cardiac arrest out of hospital with return of spontaneous circulation (ROSC) > 30 min
6. No flow time > 5 min
7. Mechanical causes for cardiogenic shock (ventricular septal defect of papillary muscle rupture)
8. Non-cardiogenic causes of shock (bradycardia, sepsis, hypovolemia, etc.)
9. Fever (Body temperature > 38.0 °C) or other evidence of sepsis
10. Onset of cardiogenic shock > 6 h before enrolment
11. Lactate > 16 mmol/L
12. Severe peripheral arterial occlusive disease precluding insertion of femoral arterial or venous catheters
13. Contra-indications for anticoagulation
14. Contra-indication for VA ECMO, e.g. unrecoverable heart and not a candidate for transplant or VAD

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
venoarterial extracorporeal membrane oxygenation (VA ECMO) for cardiocirculatory stabilization	Synchronized Cardiac Support with the icor kit	Patients with cardiogenic shock, requiring a venoarterial extracorporeal membrane oxygenation (VA ECMO) for cardiocirculatory stabilization will be treated with Synchronized Cardiac Support (SCS).

Primary Outcome Measures

Name	Time	Method
Cardiocirculatory stabilization and end-organ perfusion	up to 14 days	measured by the Change in Lactate Level

Secondary Outcome Measures

Name	Time	Method
Cardiocirculatory stabilization and end-organ perfusion	up to 14 days	measured by the following parameter: Mean Arterial Pressure, Catecholamine Support, Cardiac Index, Cardiac Output and Cardiac Afterload
Extracorporeal Life Support (ECLS) Performance	up to 14 days	measured by the following parameter: Blood Flow, Blood Pressure, Synchronization of the patient's heartbeat, Intra-hospital transportation
Maintain renal function	up to 14 days	measured by the following parameter: Fluid Balance, Renal Replacement Therapy, Creatinine and eGRF
Maintain gas exchange	up to 14 days	measured by the following parameter: Blood Gas Analysis and Mechanical Ventilation
Thermoregulation	up to 14 days	measured by the the Body Temperature

Trial Locations

Locations (2)

Krankenhaus Buchholz und Winsen gGmbH; 🇩🇪 Buchholz, Germany

Elisabeth-Krankenhaus Essen GmbH; 🇩🇪 Essen, Germany