Actively Recruiting
Evaluation of Integrated Versus Parallel Connection for Renal Replacement Therapy in ECMO Patients
Led by Hospices Civils de Lyon · Updated on 2026-01-20
158
Participants Needed
12
Research Sites
217 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Extracorporeal membrane oxygenation (ECMO) is an extra-corporeal assistance used in case of respiratory or circulatory failure. In case of circulatory failure, ECMO is in the veno-arterial configuration (VA-ECMO). VA-ECMO patients are at high risk of developing acute kidney injury (AKI) and renal replacement therapy (RRT) may be needed in 50% of ECMO patients. Although the administration of RRT in ECMO patients has major implications, no specific recommendations are currently available. The 2020 Kidney Disease: Improving Global Outcomes (KDIGO) international conference identified the evaluation of RRT in these ECMO patients as a research priority. In 2023, the two main configurations used to administer RRT in ECMO patients are an independent delivery on a separate vascular access (parallel connection) or an integration of the RRT machine directly into the ECMO circuit (integrated connection). The integrated connection may reduce infectious and bleeding complications associated with the use of a second vascular access. However, it can expose the hemofilter and circuit to excessive positive pressures that can trigger pressure alarms in the RRT machine and expose the patient to a theoretical risk of air embolism or hemolysis. Furthermore, there is currently no robust data comparing the hemofilter lifespan with the parallel or with the integrated connection, although the filter lifespan is a crucial parameter to assess the quality of the RRT delivery in the ICU. The investigators recently performed a survey of practices in this context of ECMO patients. The investigators found that both strategies (parallel and integrated connection) are widely used and can be seen as common patient care. The hypothesis tested in this study is the following: when RRT is integrated to the ECMO circuit, the hemofilter lifespan is non inferior to the one when RRT is delivered on a separate vascular access. Only VA-ECMO patients will be enrolled in this trial.
CONDITIONS
Official Title
Evaluation of Integrated Versus Parallel Connection for Renal Replacement Therapy in ECMO Patients
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Patients aged above 18 years
- Patients on VA-ECMO requiring initiation of continuous RRT during treatment
- Patients with a predicted intensive care stay longer than 24 hours
You will not qualify if you...
- Patients without vascular access suitable for new dialysis catheter insertion
- Patients with high ECMO pressures preventing direct RRT catheter connection
- Pregnant, parturient, or breastfeeding women
- Patients deprived of liberty by judicial or administrative decision
- Patients under psychiatric care
- Patients under legal protection (guardianship, curatorship)
- Patients not affiliated with a social security system
- Patients participating in another interventional renal purification research study
AI-Screening
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Trial Site Locations
Total: 12 locations
1
CHU de Bordeaux, GH Sud, Service d'anesthésie-réanimation cardiovasculaire, Hôpital cardiologique
Bordeaux, France
Actively Recruiting
2
CHU de Clermont Ferrand, Pôle de médecine péri-opératoire/Chirurgie cardiaque, Hôpital Gabriel Montpied
Clermont-Ferrand, France
Actively Recruiting
3
Centre Hospitalo Universitaire de Dijon, Unité Réanimation Cardio-Vasculaire,
Dijon, France, 21079
Actively Recruiting
4
CHU de Grenoble, Service de réanimation cardiovasculaire et thoracique, Pôle anesthésie réanimation, Hôpital Nord
Grenoble, France
Actively Recruiting
5
Centre Hospitalo Universitaire de Lille, Institut Coeur Poumon
Lille, France, 59037
Not Yet Recruiting
6
Hospices Civils de Lyon, Service d'Anesthésie-Réanimation cardiovasculaire, Hôpital Louis Pradel
Lyon, France
Actively Recruiting
7
CHU de Montpellier, Département d'anesthésie-réanimation, Pôle Cœur-poumons, Hôpital Arnaud de Villeneuve
Montpellier, France
Actively Recruiting
8
APHP, Institut de Cardiologie, Service d'anesthésie-réanimation cardiovasculaire, Hôpital de la Pitié-Salpêtrière
Paris, France
Actively Recruiting
9
APHP, Institut de cardiologie, Service de Médecine Intensive Réanimation, Hôpital Pitié-Salpêtrière
Paris, France
Actively Recruiting
10
CHU de Saint Etienne, Hôpital Bellevue, Service de Réanimation polyvalente et soins intensifs post-opératoires
Saint-Etienne, France
Actively Recruiting
11
Centre Hospitalo Universitaire de Toulouse, Hôpital Rangueil - Réanimation polyvalente
Toulouse, France, 31059
Not Yet Recruiting
12
Centre Hospitalo Universitaire de Toulouse, Unité de Chirurgie Cardiaque
Toulouse, France, 31059
Not Yet Recruiting
Research Team
F
Frank BIDAR, MD
CONTACT
T
Thomas RIMMELE, Professor MD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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