Clinician Scientist-Programm OrganAge 2020

Thema: "Impact of a VA-ECMO in combination with an extracorporeal cytokine hemoadsorbtion system in critically ill patients with cardiogenic shock."

Zusammenfassung:
500.000 people in Europe sustain cardiac shock every year [1]. Poor overall survival has triggered interest in integrating extra-corporeal support of oxygenation and pump function [2, 3] such as extracorporeal cardiopulmonary resuscitation (ECPR) using VA-ECMO [2, 4-6]. This treatment concept has recently shown promising survival rates ranging from 20 to 30% [2, 7, 8]. However during ECMO support clinical deterioration due to hyperinflammation [9-11] caused by the exposure of blood cells and molecules to the artificial surfaces of tubings, rotor and oxygenator of the ECMO circuit may occur [11, 12]. Strategies to control the systemic inflammatory response pharmacologically have shown conflicting results [11, 13]. Cytokine adsorbers provide a new technical tool for the elimination of inflammatory markers. Knowledge of the acute hemodynamic, echocardiographic effects and reduction in inflammatory markers during VA-ECMO therapy together with a cytokine adsober is rare. Our aim is to investigate the short term and intermediate term changes in haemodynamics, inflammatory biomarkers, immune system and cellular aging after implantation of a VA-ECMO in combination with an extracorporeal cytokine hemoadsorption system.