Diagnostic Accuracy of Shear Wave Elastography in detection perfusion deficits in patients with antegrade leg perfusion and VA-ECMO
- Conditions
- I74.3Embolism and thrombosis of arteries of lower extremities
- Registration Number
- DRKS00026645
- Lead Sponsor
- Klinik für Kardiologie und Angiologie I, Uniklinik Freiburg
- Brief Summary
Results We found no difference between DPC and no DPC (p = 0.115) during use of VA-ECMO. However, we detected marked lower limb muscle perfusion deficits of cannulated (58.9 ± 13.5 kPa) vs. cannula-free limb (95.7 ± 27.9 kPa: p < 0.001), applying SWE. No relationship was detected between NIRS measurements and SWE values (kPa) of both lower limbs. The mean peak systolic velocity of the popliteal artery at the cannulated side (30.0 ± 11.7 cm/s) was reduced compared to the non-cannulated side (39.3 ± 18.6 cm/s; p = 0.054). Conclusions Regardless of DPC after implantation of VA-ECMO, the gastrocnemius muscles seem to lose function due to cannula-related microcirculatory deficits. Muscle function analysis via SWE combined with NIRS might offer a sensitive indicator for early onset leg ischemia during VA-ECMO-related arterial cannulation.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Complete
- Sex
- All
- Target Recruitment
- 11
Age = 18 Jahre
ECLS (Extracorporeal Life Support)
Duration of ECLS therapy > 24 Stunden
Partial pressure of oxygen(PaO2) >=60 mmHg in the arterial blood gas (ABG)
Myocardial infarction > 48 Stunden after symptoms` beginn
Peripheral arterial disease (PAD) Stage III and IV
Subclavian-Steal Syndrome (blood pressure difference between the upper limbs > 40mmHg)
Leriche-Syndrome or another iliac artery stenosis requiring an intervention, renal and mesenterial artery stenosis
Partial arterial pressure of oxygen (PaO2) < 60mmHg at the time of recruitment
Severe anaemia, gastrointestinal bleeding or an active hemorrhagic shock (Hb < 8g/dl)
IABP/Impella as a heart assist device
Rhabdomyolisis: lack of exact CK-upper limit
Definition: CK> 10x normal value; CK-values > 5000U/l are related to severe muscle damage
Sarcoma or hemangioma of the lower limbs
Study & Design
- Study Type
- observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method This project is designed as an observational diagnostic study so that a follow-up examination is not planned. Our purpose ist to detect and present differences in muscle stiffness of patients with VA-ECMO using shear wave elastography.
- Secondary Outcome Measures
Name Time Method A possible secondary outcome could be defined as the diagnosis of lower limb ischemia.