Single centre experience of the use of ECMO

• Research type

  Research Database

• IRAS ID

  321357

• Contact name

  Sameer Patel

• Contact email

  sameerpatel2@nhs.net

• Research summary

  ECMO Database for the management of severe respiratory and/or cardiac failure at King's College Hospital

• REC name

  Yorkshire & The Humber - Leeds East Research Ethics Committee

• REC reference

  23/YH/0239

• Date of REC Opinion

  20 Nov 2023

• REC opinion

  Further Information Favourable Opinion

• Data collection arrangements

  The database will hold the following on all patients who receive ECMO for refractory respiratory and/or cardiac failure including refractory cardiac arrest (Extracorporeal-CPR).

  Demographics: Age, sex, ethnicity, Date of admission, illness severity scores, ECMO, and disease specific scores, as well as prognostic scores relating to disease, ICU and ECMO.
  Admission and longitudinal ICU blood results including: FBC, U+Es, LFTs, clotting, use of viscoelastic tests, arterial blood gases and lactate
  Biomarkers: troponin, NT-proBNP etc
  Admission and subsequent organ support requirements incl. ventilatory parameters, haemodynamic variables and use of vasoactive medication and mechanical circulatory support, renal support, plasma exchange or other liver assist device, neuromonitoring, limb perfusion monitoring
  Admission and subsequent Imaging including radiology, echocardiography, advanced haemodynamic monitoring and other techniques
  ECMO specific variables including but not limited to indication, type of support, cannulation configuration, duration, weaning outcome, weaning variables, complications, transfusion requirements, anticoagulation strategy etc
  Outcomes: survival, ICU and hospital LOS, neurological outcomes e.g. CPC grade, mRS
  ECMO follow up data through follow up clinics: Health related quality of life assessments, performance status, PTSD symptoms, sleep quality, physical symptoms, return to work
  In those with Liver transplant: indication for transplantation, liver disease scores e.g. MELD, UKELD, date of transplant, transplant technique, donor liver characteristics, graft function, patient and graft outcomes, complications, type of immunosuppression, infections etc

  Long term outcomes and further healthcare related quality of life assessments, health economic analysis, association of ethnicity, and retrospective application of any new scores using pre-obtained clinical, laboratory and imaging data.

  Retrospective and subsequently prospective data

• Research programme

  Extracorporeal membrane oxygenation (ECMO) remains a relatively novel advanced organ support modality in the UK for the management of refractory respiratory and/or cardiac failure, where conventional therapy is failing or has failed. A variety of indications and subgroup populations have been shown to have potential benefit when receiving this mode of support. In our institution populations who have been supported with ECMO include but are not limited to: 1. Post operative cardiac surgery patients 2. Cardiogenic shock secondary to ischaemic and non-ischaemic pathologies 3. Refractory cardiac arrest (ECPR - extracorporeal cardiopulmonary resuscitation) 4. Peri-liver transplantation 5. Trauma 6. Bone marrow transplant patientsThese groups remain novel and fully anonymised centre and patient data is submitted to a large international registry, the Extracorporeal Life Support Organisation (ELSO), which all UK centres subscribe to. This database however lacks granularity and relies on individual centres publishing their single centre or multicentre collaborative experience, particularly in the most novel groups e.g. peri liver transplantation and ECPR. Data from our institution will add to the evidence base which is almost exclusively limited to retrospective data. Data collection, analysis and prognostic modelling will allow descriptors of indications and modalities of support to be published, to better inform the intensive care community on who should and should not be supported.

• Research database title

  ECMO Database for the management of severe respiratory and/or cardiac failure at King's College Hospital

• Establishment organisation

  King's College Hospital

• Establishment organisation address

  King's College Hospital

  Denmark Hill

  SE5 9RS