Actively Recruiting
REMAP ECMO - Beta Receptor Modulation Trial
Led by Erasmus Medical Center · Updated on 2024-07-26
20
Participants Needed
1
Research Sites
78 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
In this phase 2, single center, randomized clinical pilot trial, investigators will study the effect of a strategy involving a reduction of beta receptor (BR) stimulation (by decreasing dobutamine dosages) and subsequent BR inhibition (through ultra-short acting betablockers), versus a (routine) strategy with continued BR stimulation through dobutamine infusion, on heart rate in patients with cardiogenic shock due to left- or bi-ventricular failure being supported by V-A ECMO.
CONDITIONS
Official Title
REMAP ECMO - Beta Receptor Modulation Trial
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Age 63 18 years
- Receiving V-A ECMO support for severe circulatory insufficiency due to left- or bi-ventricular failure
- Initiated V-A ECMO support 64 16 hours ago
- Receiving dobutamine infusion at 2 mcg/kg/min or higher
- Norepinephrine infusion at 0.4 mcg/kg/min or lower
- Heart rate 80 bpm or higher after V-A ECMO initiation, including sinus rhythm, atrial fibrillation, or atrial flutter
You will not qualify if you...
- Objection during the deferred consent procedure
- V-A ECMO used only during surgery or intervention and removed afterward
- Having a durable Left Ventricular Assist Device (LVAD)
- Polymorphic ventricular tachycardia requiring beta blocker therapy
- Isolated right ventricular failure (e.g., due to pulmonary embolism)
- Need for high dose dobutamine greater than 6.0 mcg/kg/min
- Receiving epinephrine infusion
- Signs of insufficient trans cardiac flow, including absence of aortic valve opening, pulse pressure less than 10 mmHg with intra-aortic balloon pump standby, or spontaneous contrast in the heart on echocardiography
- Contraindications, intolerance, or allergy to esmolol
- Second- or third-degree AV block
- Pregnancy
- Life expectancy less than 24 hours
- Participation in another randomized clinical trial
- Unable to start study treatment within 4 hours after randomization
- Post heart transplantation patients
AI-Screening
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Trial Site Locations
Total: 1 location
1
Erasmus Medical Center
Rotterdam, South Holland, Netherlands, 3015GD
Actively Recruiting
Research Team
C
Christiaan L. Meuwese, MD, PhD
CONTACT
M
Myrthe PJ van Steenwijk, 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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