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Shock, Cardiogenic clinical trials

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NCT ID: NCT05788211 Completed - Cardiogenic Shock Clinical Trials

REnal reCOVery After ECMO for Cardiogenic Shock (RECOVECMO)

RECOVECMO
Start date: January 1, 2022
Phase:
Study type: Observational

This retrospective study assesses long term renal outcome in patients having suffered medical or post cardiotomy refractory cardiogenic shock requiring renal replacement therapy (RRT) concomitant with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). The authors seek to establish for accurate definition of renal recovery status predicting poor long-term renal outcomes.

NCT ID: NCT05642273 Completed - Cardiogenic Shock Clinical Trials

The Effects of oXiris in Cardiogenic Shock Requiring VA-ECMO

CLEAN ECMO
Start date: November 25, 2022
Phase: N/A
Study type: Interventional

Cardiogenic shock (CS) defines a state of systemic hypo-perfusion leading to end-organ dysfunction related to cardiac pump failure and with mortality rates in the range of 27-50% according to recent reviews. Patients with CS often received mechanical circulatory support, and venoarterial extracorporeal membrane oxygenator (V-A ECMO) is an effective tool to support refractory CS while ensuring continuous organ perfusion. Patients with CS present clinical signs of systemic inflammation and elevated plasma levels of prototypical inflammatory and vasoactive mediators, including C-reactive protein (CRP), Interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFα). As data is scarce in this field, we decided to perform a prospective randomized controlled pilot study to investigate the efficacy of extracorporeal cytokine and lipopolysaccharide adsorption using Oxiris on humoral inflammation parameters, hemodynamics, and clinical outcomes in patients with CS requiring VA ECMO.

NCT ID: NCT05414643 Completed - Cardiogenic Shock Clinical Trials

Management of Acute Cardiogenic Shock at the New Brunswick Heart Centre

Team-Shock
Start date: January 14, 2021
Phase:
Study type: Observational

In Atlantic Canada, acute myocardial infarction occurs at a rate of 2.9 % of the population and is the most common cause of cardiogenic shock (CS). In many studies, acute myocardial infarction accounts for up to 80% of the patients with CS. While there are different methods of treating patients with CS, the rate of mortality has not significantly improved over the years and remains as high as 50%. Recent studies have shown that a multi-modal, team-based approach can help improve patient outcomes; however, such a standardized approach is yet to be implemented in the New Brunswick Heart Centre (NBHC). The study aims to understand the difference in outcomes between two groups of patients treated for CS: SHOCK TEAM versus non-SHOCK TEAM. This is a retrospective study of 168 patients using the data from NBHC registry and patient charts. The study duration is 1 year. The primary outcome is hospital survival. Secondary outcomes include time from diagnosis to invasive monitoring and intervention. All data will be analyzed statistically between the two groups. The end goal of the study is to establish standard guidelines to treat CS patients and improve patient survival.

NCT ID: NCT05412303 Completed - EMCO-VA Clinical Trials

Vaso-inotropic Score and ECMO-VA Support in Post-cardiotomy Cardiogenic Shock.

ECMOVIS
Start date: January 1, 2019
Phase:
Study type: Observational

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a well-established lifesaving treatment for refractory cardiogenic shock, with or without concomitant respiratory failure. VA-ECMO is usually started in presence of refractory low cardiac output syndrome following CPB weaning. Currently, there is no consensus about the best timing for implantation and initiation of VA-ECMO in this setting. Some publications have suggested that VIS score could be used to determine the necessity of VA-ECMO in cardiologic area. It was demonstrated that a VIS score between 20 and 40 may be a cut-off value to discuss the implantation of VA-ECMO. Post cardiotomy shock is a very interesting setting because the timing of cardiogenic shock is known and several bias are more controlled than in medical area. Based on the well-established ability of VIS Score in predicting mortality, we will investigate the role of the VIS Score as a determinant for early VA-ECMO implantation in patients suffering of post-cardiotomy cardiogenic shock.

NCT ID: NCT05309980 Completed - Cardiogenic Shock Clinical Trials

Outcomes in CArdiogenic SHock Patients Treated by MEchanical Circulatory suppoRt devicE : Impact of Shock Team

CASHMERE
Start date: April 1, 2021
Phase:
Study type: Observational

In this before-after monocenter study, the authors teste the hypothesis that the implementation of a dedicated shock team could improve the outcome of patients with refractory cardiogenic shock assisted by mechanical circulatory support.

NCT ID: NCT05271227 Completed - Cardiogenic Shock Clinical Trials

Volume Responsiveness By Ultrasound Of Carotid Blood Flow In Patients With Cardiogenic Shock

Start date: March 25, 2020
Phase:
Study type: Observational

Resuscitation of critically ill patients has changed since the advent of goal directed therapy. Today, practitioners providing fluid resuscitation are attentive of the danger associated with volume depletion while being aware of the morbidity of volume overload. Fluid resuscitation must be rapid, precise, and individually tailored to each patient based on reliable data obtained by various means inside ICU setting. There is no non-invasive method that can reliably and accurately identify fluid responsiveness. As such, in patients with undifferentiated shock, treatment often involves empiric fluid administration, in the hopes that volume expansion will increase preload, which will then serve to increase cardiac output (CO). However, for patients on the flat portion of the Starling curve, aggressive fluid administration results in no appreciable increase in CO and may be detrimental to hemodynamically unstable patients.

NCT ID: NCT05102734 Completed - Circulatory Shock Clinical Trials

Physiologic Effect of Topical Nitroglycerin on Microcirculation Capacity in Patients With Circulatory Shock.

Start date: September 1, 2021
Phase:
Study type: Observational

This is an open-label, single center, trial that will enroll up to 25 participants with circulatory shock after cardiac surgery. Participants will be administered a topical sublingual nitroglycerin solution and assessed for changes microcirculatory blood flow using incident dark field microscopy.

NCT ID: NCT04985708 Completed - Cardiogenic Shock Clinical Trials

Carolinas Cardiogenic Shock Initiative

CCSI
Start date: May 1, 2019
Phase:
Study type: Observational [Patient Registry]

To determine if deferred or delayed implantation of Impella device based on shock severity index is non-inferior with respect to 1 month and 1 year mortality compared to standard clinical protocols that do not differentiate based on shock severity in adult patients following an initial diagnosis of acute myocardial infarction complicated by cardiogenic shock (AMICS).

NCT ID: NCT04925518 Completed - Clinical trials for Acute Respiratory Distress Syndrome

Closed Loop Mechanical Ventilation and ECMO

Start date: March 6, 2016
Phase: N/A
Study type: Interventional

Mechanical ventilation and ECMO are both technologies interacting on gas exchange. Nevertheless, besides a consensus paper, no evidence-based guidelines regarding protective lung ventilation on ECMO exist to date. Mechanical Ventilation with Intellivent-ASV, an algorithm driven, closed loop system, provides an opportunity to standardize ventilation on ECMO. We propose and validate lung protective ventilation with a closed loop ventilation mode in patients with ECMO.

NCT ID: NCT04917497 Completed - Cardiogenic Shock Clinical Trials

Levosimendan Infusion in Critically Ill Patients With Cardiogenic Shock

Start date: June 30, 2011
Phase:
Study type: Observational

To determine whether Levosimendan infusion in patients with cardiogenic shock and cardiorenal syndrome refractory to standard inotropic therapy, improves hemodynamics and renal function, whilst being safe.