[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"trial:NCT07141524":3,"trial-entities:NCT07141524":77,"trial-summary:NCT07141524":83},{"id":4,"nct_id":4,"org_study_id":5,"brief_title":6,"official_title":7,"overall_status":8,"completion_date":9,"status_verified_date":10,"last_update_date":11,"start_date":12,"sponsor_name":13,"lead_sponsor_class":14,"has_dmc":15,"brief_summary":16,"detailed_description":17,"conditions":18,"keywords":20,"study_type":24,"primary_purpose":25,"phases":26,"enrollment_info":28,"interventions":31,"primary_outcomes":37,"secondary_outcomes":42,"sex":43,"minimum_age":44,"maximum_age":45,"healthy_volunteers":15,"eligibility_criteria":46,"std_ages":58,"locations":61,"central_contacts":73,"overall_officials":74,"references":75,"see_also_links":76},"NCT07141524","2025P000675","Optimizing Breathing and Blood Flow in Patients Treated With VA ECMO","Ventilation-Perfusion Matching and PEEP Titration in Patients Undergoing Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation (VA ECMO)","ENROLLING_BY_INVITATION","2027-02-28","2025-10","2026-02-02","2026-01-27","Beth Israel Deaconess Medical Center","OTHER",false,"The aim of this study is to characterize ventilation\u002Fperfusion (V\u002FQ) matching in adult patients receiving peripheral VA ECMO support while on mechanical ventilation, and to evaluate the impact of PEEP titration guided by Electrical Impedance Tomography (EIT) and esophageal pressure measurements on lung mechanics and V\u002FQ optimization.","The investigators hypothesize that an individualized PEEP titration guided by esophageal pressure measurements and Electrical Impedance Tomography can reduce lung overdistention, enhance lung recruitment, and improve V\u002FQ matching by optimizing regional ventilation and perfusion also in VA ECMO.\n\nOur objectives are:\n\n1. To describe V\u002FQ matching in patients undergoing mechanical ventilation during peripheral VA ECMO support.\n2. To explore the impact of PEEP titration based on esophageal pressure and EIT in terms of lung mechanics and V\u002FQ matching.",[19],"VA-ECMO",[21,22,23],"Ventilation \u002F perfusion","ECMO","Mechanical Ventilation","INTERVENTIONAL","BASIC_SCIENCE",[27],"NA",{"count":29,"type":30},10,"ESTIMATED",[32],{"type":14,"name":33,"description":34,"armGroupLabels":35},"Physiology measurements","Measurement of lung perfusion (via EIT) and transpulmonary pressure (via esophageal manometry) during decremental PEEP trial",[36],"Lung physiology assessment",[38],{"measure":39,"description":40,"timeFrame":41},"V\u002FQ match","Primary outcome measure:\n\nReduction in shunt fraction (expressed in %)\n\nSecondary outcome measure:\n\nReduction in dead space (expressed as volume)\n\nRespiratory mechanics will be recorded before and after best PEEP. Ventilation (L\u002Fmin)\u002FPerfusion (L\u002Fmin) \\[V\u002FQ\\] ratio comparing baseline with best PEEP (after PEEP optimization trial).","1 hour",[],"ALL","18 Years",null,{"inclusion":47,"exclusion":52,"raw_text":57},[48,49,50,51],"Adults (≥18 years) undergoing mechanical ventilation during peripheral VA ECMO support for cardiogenic shock, cardiac arrest, or refractory heart failure.","On ECMO support for at least 6 hours","Swan-Ganz catheter required as standard clinical care","Clinically stable in the estimation of the study investigator",[53,54,55,56],"Contraindications to EIT (e.g., presence of pacemaker or IMPELLA device for electrical interference)","Patients without pulmonary flow (non-pulsatile pulmonary prSessure)","Patients with known pulmonary embolism","Imminent withdrawal of life support","Inclusion Criteria:\n\n* Adults (≥18 years) undergoing mechanical ventilation during peripheral VA ECMO support for cardiogenic shock, cardiac arrest, or refractory heart failure.\n* On ECMO support for at least 6 hours\n* Swan-Ganz catheter required as standard clinical care\n* Clinically stable in the estimation of the study investigator\n\nExclusion Criteria:\n\n* Contraindications to EIT (e.g., presence of pacemaker or IMPELLA device for electrical interference)\n* Patients without pulmonary flow (non-pulsatile pulmonary prSessure)\n* Patients with known pulmonary embolism\n* Imminent withdrawal of life support",[59,60],"ADULT","OLDER_ADULT",[62,70],{"facility":13,"city":63,"state":64,"zip":65,"country":66,"geoPoint":67},"Boston","Massachusetts","02115","United States",{"lat":68,"lon":69},42.35843,-71.05977,{"facility":13,"city":63,"state":64,"zip":71,"country":66,"geoPoint":72},"02215",{"lat":68,"lon":69},[],[],[],[],{"nct_id":4,"conditions":78,"biomarkers":82},[79,80,81],"Cardiac Arrest","Cardiogenic Shock","Heart Failure",[],{"nct_id":4,"found":15,"summary":45,"prompt_version":45}]