This is a retrospective, observational study and will investigate the clinical predictive value of and change in muscle quantity and quality in critically ill patients with severe respiratory failure requiring veno-venous extracorporeal membrane oxygenation (VV-ECMO).
The use of veno-venous extra-corporeal membrane oxygenation (VV-ECMO) for severe respiratory failure - mainly hypoxaemia - has increased over recent years. Similar to the general population in the Intensive Care Unit (ICU), these patients become deconditioned, severely weak (ICU acquired weakness- ICUAW) and require prolonged rehabilitation after disconnection from VV-ECMO. However, data regarding the magnitude of muscle wasting and recovery in this specific group is lacking. Both poor muscle quantity and quality have been found to be a predictor or poor outcome. As all patients receiving VV-ECMO at our hospital will get an initial CT scan of their chest, abdomen and pelvis, these CT scans will be used to measure muscle quantity and quality of different muscle groups of the abdomen at admission and then using any follow-up CT scan performed within 10 days. In addition, the relationship between the loss of muscle over the course of VV-ECMO and perceived recovery of renal function at ICU discharge will be investigated.
Study Type
OBSERVATIONAL
Enrollment
215
Guy's and St Thomas' NHS Foundation Trust
London, United Kingdom
All cause mortality
Using total muscle quantity and quality measured from CT slice of the third lumbar region.
Time frame: On ECMO (expected to be about 10 days)
Length of ECMO duration
Using total muscle quantity and quality measured from CT slice of the third lumbar region.
Time frame: The total duration on ECMO (expected to be an average of 10 days)
Length of ICU admission
Using total muscle quantity and quality measured from CT slice of the third lumbar region.
Time frame: The total duration of ICU admission (expected to be around 2 weeks)
Length of hospital stay
Using total muscle quantity and quality measured from CT slice of the third lumbar region.
Time frame: The total duration of hospital admission (expected to be around 28 days)
Length of ventilation
Using total muscle quantity and quality measured from CT slice of the third lumbar region.
Time frame: Total duration of mechanical ventilation during intensive care unit stay (expected to be around 10 days)
Discharge destination
Using total muscle quantity and quality measured from CT slice of the third lumbar region.
Time frame: After discharge from hospital (expected to be around 28 days)
Sequential changes in the muscle quantity over time
Using total muscle quantity measured from CT slice of the third lumbar region.
Time frame: The total duration of ECMO (expected to be around 10 days)
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Sequential changes in muscle quality over time
Using total muscle quality measured from CT slice of the third lumbar region.
Time frame: The total duration of ECMO (expected to be around 10 days)
Relationship between muscle loss and total nutrition received
Using total muscle quantity measured from CT slice of the third lumbar region.
Time frame: The total duration of ECMO (expected to be around 10 days)
Relationship between muscle loss and rehabilitation goals met
Using total muscle quantity measured from CT slice of the third lumbar region.
Time frame: The total duration of ECMO (expected to be around 10 days)
All cause mortality
Using total muscle quantity and quality measured from CT slice of the third lumbar region.
Time frame: Intensive Care Unit Stay (expected to be about 2 weeks)
All cause mortality
Using total muscle quantity and quality measured from CT slice of the third lumbar region.
Time frame: 6 months post-ICU discharge
All cause mortality
Using total muscle quantity and quality measured from CT slice of the third lumbar region.
Time frame: Hospital discharge (expected to be about 28 days)