Validation of Techniques for Hemodynamic Monitoring and Prediction of Fluid Responsiveness in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation - A Prospective Diagnostic Accuracy Study (HemodynamECMOnitoring-VA Study)

What this Trial Is About

Researchers are evaluating the accuracy of different methods for monitoring blood circulation and predicting fluid responsiveness in patients receiving venoarterial extracorporeal membrane oxygenation (VA ECMO). VA ECMO is a treatment that supports circulation in patients with severe heart failure or cardiac arrest by oxygenating blood outside the body and returning it to the bloodstream. The study aims to validate common hemodynamic monitoring tools in this specific setting, as artificial circulation may affect measurement accuracy. Participants will undergo serial hemodynamic assessments throughout their ECMO therapy. These assessments use devices like transthoracic echocardiography, uncalibrated pulse contour analysis, transpulmonary thermodilution, bioreactance, and esophageal doppler. Fluid responsiveness will be tested using maneuvers such as passive leg raising, respiratory pulse pressure variation, stroke volume variation, inferior vena cava ultrasound, and end-inspiratory or end-expiratory occlusion tests. Fluid boluses may be given to verify responsiveness. During the study, researchers will collect repeated measurements of cardiac output, tricuspid annular plane systolic excursion, tissue doppler imaging tricuspid annular velocity, and other hemodynamic variables throughout ECMO therapy and up to seven days after ECMO removal. These data will help compare the performance of different monitoring techniques. The study duration varies per participant, ranging from a few days to up to 24 weeks of ECMO therapy, with continued monitoring after treatment ends.

Hemodynamic Monitoring and Fluid Responsiveness in Venoarterial Extracorporeal Membrane Oxygenation (VA ECMO) - "HemodynamECMOnitoring-VA Study"