Pulmonary Physiologic Assessment of Patients on Veno-arterial Extracorporeal Membrane Oxygenation (VA ECMO)
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.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Contacts and Locations
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02135
- Massachusetts General Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- 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
Exclusion Criteria:
- Known pre-existing significant pulmonary pathology
- Pacemaker or implanted cardiac defibrillator
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percent of total distribution of ventilation by region, on given ventilator settings
Time Frame: 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.
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Within 24-48 hours of ECMO cannulation
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
90-day mortality
Time Frame: 90 days
|
90 days
|
|
Time on VA-ECMO
Time Frame: 14 days, 90 days
|
14 days, 90 days
|
|
Need to transition to VV-ECMO
Time Frame: 14 days, 90 days
|
14 days, 90 days
|
|
Time on mechanical ventilation
Time Frame: 14 days, 90 days
|
14 days, 90 days
|
|
Time in ICU
Time Frame: 14 days, 90 days
|
14 days, 90 days
|
|
Incidence of ventilator-associated pneumonia
Time Frame: 14 days, 90 days
|
14 days, 90 days
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2020P003054
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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