None listed
Conditions
Brief summary
V-A ECMO is a specialised cardiorespiratory support for patients with severe heart dysfunction. ECMO supports the circulation via a pump, and gas exchange (oxygen and carbon dioxide) occurs via an external membrane. ECMO patients are vulnerable to both rapid weight loss as well as complications related to overfeeding. Therefore the provision of the correct amount of nutrition is an essential element of care. However, we are currently uncertain of how to accurately determine the energy they require, as gas exchange across the external membrane means current measures are inaccurate. The aim of this study is to explore the feasibility of measuring carbon dioxide production and oxygen consumption across the ECMO membrane as well as the lung in 30 mechanically ventilated critically ill patients receiving V-A ECMO at two points during Intensive Care Unit admission. Exact energy expenditure has not previously been established in V-A ECMO. The completion of this study will work towards improving the accuracy of nutrition delivery in this patient group.
Interventions
Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is a specialised cardiorespiratory support for patients with severe heart dysfunction. ECMO supports the circulation via a pump, and gas exchange (oxygen and carbon dioxide) occurs via an extracorporeal membrane. ECMO patients are vulnerable to both rapid weight loss as well as complications related to overfeeding. Therefore the provision of the correct amount of nutrition is an essential element of care. However, we are currently unce
Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is a specialised cardiorespiratory support for patients with severe heart dysfunction. ECMO supports the circulation via a pump, and gas exchange (oxygen and carbon dioxide) occurs via an extracorporeal membrane. ECMO patients are vulnerable to both rapid weight loss as well as complications related to overfeeding. Therefore the provision of the correct amount of nutrition is an essential element of care. However, we are currently uncertain of how to accurately determine the energy they require, as gas exchange across the external membrane means current measures are inaccurate. In this single-centre prospective observational study, the feasibility of measuring carbon dioxide production and oxygen consumption across the ECMO membrane as well as the lung will be determined in mechanically ventilated ECMO critically ill patients. Exact energy expenditure has not previously been established in V-A ECMO. This study will aim to improve the accuracy of nutrition delivery in this patient group. The aim is to recruit a convenience sample of 30 patients and to measure energy expenditure within 72 hours of commencement of V-A ECMO and to repeat measurements on day seven following ECMO commencement.
Sponsors
The Alfred, Alfred Health
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Critically ill adult patients aged equal to or greater than 18 years • Commenced on V-A ECMO for any reason • Expected to require mechanical ventilation for at least 48 hours from initiation of ECMO • Expected to remain in the ICU and on ECMO for at least 48 hours
Exclusion criteria
• Patients with a poor prognosis where death is imminent in the subsequent 24 hours • Participation in the study is not in the interest of the patient in the opinion of the treating physician
Outcome results
None listed