CLots and Oxygen in Va-ExtracorpoReal membrane oxygenation (CLOVER) study
Va-体外真实膜氧合 (CLOVER) 研究中的 CLots 和氧气
基本信息
- 批准号:10370823
- 负责人:
- 金额:$ 17.35万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-01-21 至 2026-12-31
- 项目状态:未结题
- 来源:
- 关键词:AcuteAcute Brain InjuriesAddressAdultAnticoagulationAutomobile DrivingAwardBiometryBloodBlood CellsBlood PlateletsBlood coagulationBlood gasBrainBrain InjuriesBrain hemorrhageCOVID-19CannulationsCardiac Surgery proceduresCardiopulmonary ResuscitationCaringCerebral EmboliCerebrovascular CirculationCerebrumClinical InvestigatorClinical TrialsClinical Trials DesignCoagulation ProcessCollaborationsComplicationCritical CareCritical IllnessDataData ScienceDevicesEchocardiographyExposure toExtracorporeal Membrane OxygenationFrequenciesFundingFutureGoalsGrantGuidelinesHeart ArrestHeart failureHospitalsHourHyperoxiaHypoxic-Ischemic Brain InjuryInjuryInterdisciplinary StudyInterventionIschemic StrokeKnowledgeLeadLifeMechanicsMentorsMethodologyMethodsMonitorMorbidity - disease rateNervous System TraumaNeurologicNeurological outcomeNeurologyOutcomeOxygenOxygen Therapy CareOxygenatorsPartial PressurePatientsPerfusionPhysiologyProductionProspective StudiesProtocols documentationPumpRefractoryReperfusion InjuryReperfusion TherapyResearchRespiratory FailureRiskRisk FactorsRunningSavingsScientistSeveritiesShockSideSignal TransductionStrokeTestingThrombophiliaThrombosisThrombusTissuesTrainingTranscranial Doppler UltrasonographyTraumaUnited StatesUnited States National Institutes of HealthWorld Health Organizationbaseblood damagecareercareer developmentexperienceimprovedinterestischemic injuryleft ventricular assist devicemechanical circulatory supportmodifiable riskmortalitymultidisciplinaryneurophysiologynovelnovel coronavirusoxygen toxicitypandemic coronaviruspatient orientedpreventprospectiverespiratoryrestoration
项目摘要
ABSTRACT/SUMMARY
Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) is a life-saving intervention for patients with
refractory cardiac failure, and the frequency of its use continues to increase in the United States. However, during
ECMO, exposure of blood to the non-biological material in the ECMO circuit and to trauma from the pump or
oxygenator initiates the coagulation cascade. Consequently, patients become vulnerable to stroke and require
systemic anticoagulation. VA-ECMO carries a risk of arterial circuit thrombosis as well as microemboli from
platelet aggregates or damaged blood cells, which is hypothesized to cause acute ischemic stroke in patients
on ECMO support. In addition, as VA-ECMO immediately restores perfusion to brain, routine administration of
high-percentage oxygen for the first hours after ECMO cannulation is hypothesized to cause acute brain injury
and worsening of injured brain with reperfusion injury. This neurologic injury early after ECMO cannulation
provides an opportunity for intervention strategy when the relation between acute brain injury and these
modifiable risk factors, ECMO circuit clots, and hyperoxia, is established.
For many years, I have had a strong interest in the effects of arterial-sided thrombosis and hyperoxia on acute
brain injury and neurologic outcome. Additionally, I have extensive research experience in brain injury and
neurologic outcome in adult patients with mechanical circulatory support devices. I am the director of adult ECMO
research at Johns Hopkins Hospital and am involved with studies that have helped to define the association
between left ventricular assist devices and neurologic injury. My interest in mechanical circulatory support
devices has led me to address key knowledge and practice gaps in VA-ECMO, the concomitant acute brain
injury, and its impact on neurologic outcome. The proposed research addresses two important “modifiable”
factors—blood clots and hyperoxia—in adult VA-ECMO patients and their relation to neurologic outcome. I
propose to investigate whether arterial-sided ECMO-generated clots are associated with acute ischemic stroke
(Aim 1) and the effects of hyperoxia within 24 hours of ECMO cannulation on neurologic outcome at hospital
discharge (Aim 2). Should ECMO-generated clots and hyperoxia prove to carry a substantial risk for acute brain
injury and unfavorable neurologic outcome, I will propose clinical trials to target these modifiable factors by
strategies such as using conservative oxygen therapy after ECMO cannulation and changing anticoagulation
approaches to reduce cerebral emboli. This grant will equip me with the content, methodological expertise, and
multidisciplinary collaboration required to be successful as an independent NIH-funded, patient-oriented
clinician-scientist in collaboration with cardiac surgery, critical care, and neurology. This award will also provide
critically novel discoveries that may likely impact care related to arterial-sided ECMO-generated clots and
hyperoxia in these vulnerable adult patients with critical illness.
抽象/总结
项目成果
期刊论文数量(0)
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Sung-Min Cho其他文献
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CLots and Oxygen in Va-ExtracorpoReal membrane oxygenation (CLOVER) study
Va-体外真实膜氧合 (CLOVER) 研究中的 CLots 和氧气
- 批准号:
10553664 - 财政年份:2022
- 资助金额:
$ 17.35万 - 项目类别:














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