SPECKLE ECMO

  • Research type

    Research Study

  • Full title

    Evaluation of speckle tracking parameters as predictors of successful VA ECMO weaning procedure. A prospective observational pilot study.

  • IRAS ID

    241001

  • Contact name

    Susanna Price

  • Contact email

    s.price@rbht.nhs.uk

  • Sponsor organisation

    Royal Brompton and Harefield NHS Foundation Trust (RB&HFT)

  • Duration of Study in the UK

    1 years, 2 months, 0 days

  • Research summary

    This project is non-commercial study which aims for assessing wheter measurements obtained through speckle tracking (Left Ventricle (LV) longitudinal and circumferential strain, Right Ventricle (RV) longitudinal strain) can give additional information to conventional echocardiograhic parameters (left ventricular outflow tract (LVOT) velocity time integral (VTI) increase, etc.) in identifying patients who develop adverse outcomes 30 days post successfully weaning from VA ECMO (liberation not for palliation). It is a prospective observational non-blinded pilot study. It will be assessed whether the population experiencing the outcomes of interest (death within 30 days from VA ECMO liberation, hospital admission for a new episode of cardiogenic shock or heart failure within 30 days from VA ECMO liberation, need for new mechanical circulatory support within 30 days from VA ECMO liberation) and the population not experiencing these outcomes have different values of strain (LV longitudinal, LV circumferential and RV longitudinal strain) during the weaning study.
    VA ECMO can hemodynamically support patients in refractory cardiogenic shock due to medical, postcardiotomy, or post-cardiac arrest. VA ECMO can be used as a bridge to cardiac transplantation, to a long-term ventricular assist device (VAD), or until recovery of myocardial function. Weaning success from VA ECMO is defined as device removal and no further requirement for mechanical support. Management of VA ECMO weaning is difficult, and to date, no clinical or echocardiographic study has specifically evaluated predictors of the success of weaning. At present, the weaning strategies are based on Doppler VTI and ejection fraction (EF). According to the results of previous research, only 41% of patients who were successfully liberated from VA ECMO were subsequently discharged alive, with the majority of these patients dying in hospital. Heart failure and multiple organ failure were the principal causes of death in this study.

  • REC name

    London - Harrow Research Ethics Committee

  • REC reference

    18/LO/0946

  • Date of REC Opinion

    19 Oct 2018

  • REC opinion

    Further Information Favourable Opinion