Objective: 1. To evaluate the consistency of cardiac output measured by different hemodynamic monitoring methods in patients with VA-ECMO 2. To evaluate whether different hemodynamic monitoring methods can accurately detect the trend of cardiac output changes
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been used for profound cardiogenic shock to bridge to decision,ventricular assist devices,or transplant.Close monitoring of cardiac output, especially in patients before and after intervention (such as volume expansion, diuresis, vasoconstriction, vasodilation therapy), can help to adjust the treatment strategy. Hemodynamic monitoring in ECMO patients requires familiarity with the underlying pathophysiology and circulatory mechanics of extracorporeal flow.Limited to the actual clinical situation of patients, one or two hemodynamic monitoring methods may be accepted. Is there consistency between different hemodynamic monitoring results? And whether hemodynamic monitoring can accurately detect the changes of these parameters before and after intervention is an important issue in clinical practice. This study will provide important reference for VA-ECMO patients how to choose appropriate hemodynamic monitoring tools and how to interpret the results of hemodynamic monitoring.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
20
In the Trendelenburg position, the body is laid supine with the feet higher than the head by 15-30 degrees. The venous return increases in the trendelenburg position which in turn increases the stroke volume.
Dobutamine was infused intravenously at the initial dose of 2.5 ug/kg/min. Echocardiography was performed after 5-10 minutes of continuous infusion, and hemodynamic data were recorded.
Zhongshan hospital, Fudan university
Shanghai, China
RECRUITINGBaseline Cardiac Output measurement
Cardiac Output measured at baseline position( in a supine position with the head elevated to 15° for baseline measurements )
Time frame: within1 minute at baseline position
Cardiac Output measurement afterTrendelenburg Maneuver
Cardiac Output measured after Trendelenburg Maneuver
Time frame: 1 minute after starting Trendelenburg Maneuver
Cardiac Output measurement after Dobutamine stress test
Cardiac Output measured after dobutamine stress test
Time frame: 5 minutes after dobutamine stress test
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