Cardiovascular Shock, Respiratory Failure
Conditions
Brief summary
Extra-corporeal membrane oxygenation (ECMO) can temporarily help patients gain time to wait for cardiopulmonary recovery or further treatment in patients with cardiopulmonary failure. Whether the blood flow provided by the ECMO can maintain the perfusion of various organs is an important factor affecting survival. Some ECMO patients died after the complication of sepsis. Our previous pilot analysis has recognized several ECMO patients with complicated sepsis has high endotoxin activity level. Endotoxemia can also occur in heart surgery and after cardiopulmonary bypass, trauma, organ transplantation, and out-of-hospital cardiac arrest patients. These trials used endotoxin activity analysis (EAA, EAATM, Spectral Diagnostics Inc., Canada) to analyze endotoxin activity. In addition, studies have indicated that the combination of procalcitonin (PCT) concentration and EAA activity can improve the accuracy of predicting sepsis. The primary aim of this study is to detect endotoxin activity in patients with ECMO support and compare whether the prognosis was associated with different level of EAA activity. The secondary aims are to analyze the risk factors leading to high EAA activity and investigate the diagnostic value of septic shock combining PCT examination. We suggest that the results of this study may help the ECMO medical team identify patients at high risk for septic shock and conduct adequate managements to improve patient survival and quality of life after survival.
Interventions
Cardiovascular shock patients received extra-corporeal membrane oxygenation suppot.
Sponsors
National Taiwan University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* patients with ECMO support
Exclusion criteria
* \< 20 years old or \> 90 years old * not be able to collect blood sample within 48 hours after placement of ECMO * change plan to palliative care and plan to remove ECMO * non-native speakers
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Endotoxin activity level | within 48 hours | Endotoxin activity level is measured by endotoxin activity analysis kit |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Endotoxin activity level | within 24 hours | Endotoxin activity level is measured by endotoxin activity analysis kit |
| Procalcitonin level | within 48 hours | Procalcitonin level in ECMO patients |
| Cystatin C level | within 48 hours | Cytatin C level in ECMO patients |
| Diamine oxidase level | within 48 hours | Diamine oxidase level in ECMO patients |
Countries
Taiwan
Outcome results
None listed