Official Title: Randomized Embedded Multifactorial Adaptive Platform in ExtraCorporeal Membrane Oxygenation - Beta Receptor Modulation Trial
Status: RECRUITING
Status Verified Date: 2024-07
Last Known Status: None
Delayed Posting: No
If Stopped, Why?: Not Stopped
Has Expanded Access: No
If Expanded Access, NCT#: N/A
Has Expanded Access, NCT# Status: N/A
Acronym: None
Brief Summary: In this phase 2 single center randomized clinical pilot trial investigators will study the effect of a strategy involving a reduction of beta receptor BR stimulation by decreasing dobutamine dosages and subsequent BR inhibition through ultra-short acting betablockers versus a routine strategy with continued BR stimulation through dobutamine infusion on heart rate in patients with cardiogenic shock due to left- or bi-ventricular failure being supported by V-A ECMO
Detailed Description: Despite the great benefits of Venoarterial ExtraCorporeal Membrane Oxygenation V-A ECMO and its rapidly increasing usage even today 30 till 70 percent of patients cannot be weaned from ECMO support and up to 50 percent of patients will eventually die in the first year These high incidences of mortality and failure to wean from V-A ECMO support seem largely attributable to failure of the heart to recover in the context of inotropic drug administration and high sympathetic drive due to severe illness further stressing an already failing heart As V-A ECMO support creates a safety window where organ perfusion no longer relies on native cardiac output therapeutic focus could be shifted to cardioprotective treatments Cardioprotective treatments typically include beta blockers BB which have unequivocally shown benefits on mortality and morbidity in other patient categories with heart failure with reduced ejection fraction HFrEF
The investigators hypothesize that in selected patients with cardiogenic shock undergoing V-A ECMO support application of BBs is feasible and safe and can effectively reduce heart rate