Columbus, OH – Investigators at Nationwide Children’s Hospital are evaluating a new way to assess cardiac function while children are supported by mechanical life support, thanks to a $110,000 two-year grant from the American Heart Association.
Extracorporeal membrane oxygenation (ECMO) is a form of mechanical life support which is used to help critically ill children, especially in cases of cardiac failure. A form of ECMO called veno-arterial (VA) ECMO can be used for poor heart function and provides support that can lead to patient recovery, transplantation if appropriate and eligible or complications of ECMO therapy lead to stopping care. Long-term use of VA-ECMO can lead to complications including infection, organ injury, stroke and bleeding.
“A delicate balance exists between keeping patients on mechanical support until they recover cardiac function and removing them before complications arise,” said Andrew Yates, MD, a pediatric cardiologist and critical care physician in The Heart Center at Nationwide Children’s Hospital and principal investigator on the grant. “Unfortunately, there is currently no standardized, quantifiable way to assess cardiac function while patients are supported by VA-ECMO.”
Traditional ultrasound measures of cardiac function are not reliable in this setting since VA-ECMO manipulates how blood flows through the heart.
Using National Clinical Research Program funding from the American Heart Association, Dr. Yates, who is also with The Ohio State University College of Medicine, and colleagues will investigate whether traditional or newer advanced ultrasound measurements obtained during different levels of support from the ECMO pump can predict which patients will be safely able to stop VA-ECMO support.
The study aims to develop a non-invasive measure of cardiac function that is accurate with VA-ECMO support and can be used clinically to decrease complications and improve outcomes for some of the sickest children.