Microcirculation in Venoarterial Extracorporeal Membrane Oxygenation Life Support

National Taiwan University

Status: Completed

Conditions: Respiratory Failure; Heart Failure

Treatments: Device: Extra-corporeal membrane oxygenation life support

Study type: Observational

Funder types: Other

Identifiers

NCT02393274

201412045RINA

Details and patient eligibility

About

Extra-corporeal membrane oxygenation (ECMO) life support system can provide both cardiac and respiratory support to patients with heart and respiratory failure. It can save time for these organs to recovery or for these patients to receive further management. However, many patients will die in spite of ECMO support. One of the key factor is whether the blood flow provided by the ECMO can meet the requirement of organ perfusion. The adequacy of macrocirculation may be determined by arterial pressure and minute blood flow of ECMO. However, the adequacy of microcirculation remains as a major unresolved clinical problem. This is a prospective observational clinical trial. The sublingual microcirculation will be examined with the incident dark field video microscope within 6 hours after venoarterial ECMO placement, and then at 24 h, 48 h, 72 h, and 96 h. The severity of multiple organ injury and clinical data will be recorded as well. The major parameters of microcirculation include total small vessel density, perfused small vessel density, and microvascular flow index. The sublingual microcirculation will also be examined before weaning off ECMO, within 6 hours after ECMO removal, and then at 24 h, 48 h, and 72 h. Serum level of endothelial cell specific molecule-1 at specific time points will be examined. The data of 14-day mortality, 28-day mortality, duration of ECMO support, and intensive care unit stay will be recorded. This study aims primarily to investigate the relationship between microcirculation and prognosis of these patients. This study will also investigate the relationship among serum level of endothelial cell specific molecule-1, microcirculation, and prognosis of these patients. Wish the results of this study can be applied in further research to help to improve the quality of ECMO care.

Enrollment: 48 patients

Sex: All

Ages: 20 to 79 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients who require venoarterial extra-corporeal membrane oxygenation (ECMO) life support

Exclusion criteria

• who can not take an examination of sublingual microcirculation within 6 hours after placement of venoarterial ECMO support
• Non-native speakers

Trial design

48 participants in 2 patient groups

28-day Survival

Description:

survive for at least 28 days after placement of extra-corporeal membrane oxygenation life support

Treatment:

Device: Extra-corporeal membrane oxygenation life support

28-day Nonsurvival

Description:

not survive for 28 days after placement of extra-corporeal membrane oxygenation life support

Treatment:

Device: Extra-corporeal membrane oxygenation life support