Extracorporeal Membrane Oxygenation and Cerebral Blood Flow Velocity Evaluated by Transcranial Doppler
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Extracorporeal Membrane Oxygenation Complication
- Sponsor
- University Hospital, Toulouse
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Cerebral blood flow velocities evolution
- Last Updated
- 8 years ago
Overview
Brief Summary
To determine how venoarterial extracorporeal membrane oxygenation (ECMO) affects cerebral blood flow velocity (CBFV) measured by transcranial doppler (TCD), to determine whether specific changes in cerebral blood flow velocity may be associated with neurologic injury and to determine modifications of CBFV after withdrawal of ECMO.
Detailed Description
Venoarterial Extracorporeal membrane oxygenation (ECMO) is used in adult with refractory cardiac failure as a life-saving measure. Adults treated with ECMO survived to hospital discharge in 21,8% to 65,4% of cases. Neurologic complications such as intracranial hemorrhage, anoxia and ischemia are major causes of death and long-term disability in ECMO patients (7% to 14%). Current neurological monitoring techniques are insufficient to predict which critically ill patient receiving ECMO therapy will suffer from neurologic injury. Even after a clinical suspicion of neurologic injury, diagnosis can be difficult. TCD is commonly used to monitor the CBFV of traumatic brain injury. There are no reports that evaluate CBFV of patients requiring ECMO therapy. Patient will have to do both echocardiography and TCD to evaluate cardiac output and CBFV. We will repeat these dopplers every 24 hours until ECMO withdrawal and one day after explantation.
Investigators
Eligibility Criteria
Inclusion Criteria
- •adult patient who receiving ECMO therapy
Exclusion Criteria
- •cervico-encephalic vasculopathy
- •lacked an acoustic window allowing for adequate TCD examination
- •stroke in medical past.
Outcomes
Primary Outcomes
Cerebral blood flow velocities evolution
Time Frame: 24 hours
Cerebral blood flow velocities evolution over the time
The correlation of Cerebral blood flow velocities with the variation of the cardiac output and ECMO flow.
Time Frame: 24 hours
The correlation with the variation of the cardiac output and ECMO flow.
Secondary Outcomes
- Relation between acute neurologic injury and variation of CBFV(24 hours)
- Modification of the CBFV detected by TCD after the withdrawal of the ECMO.(24 hours)
- Relation between the CBFV, the NIRS, the cardiac flow and the ECMO flow.(24 hours)