1. The gas eXchange eXtracorporeaL Techniques (XXL) Study
Hearts of ECMO is now partnered with the International ECMO Network, a worldwide group of academic institutions dedicated to supporting high quality, high impact research in the field of extracorporeal life support for patients with cardiac and respiratory failure.1 The Chair of the Executive Committee is Daniel Brodie, M.D. of Columbia University, who was the Attending Physician that managed Noah’s ECMO and saved his life.
With the help of the International ECMO Network, Hearts of ECMO plans to support the gas eXchange eXtracorporeaL Techniques (XXL) Study. The study will be led by Eddy Fan, M.D. and Laurent Brochard, M.D., from the Interdepartmental Division of Critical Care Medicine at the University of Toronto, who are also well established in the ECMO field and members of the International ECMO Network.
Currently, there are no consensus guidelines for when ECMO should be utilized.23 The XXL study will aim to establish appropriate criteria for ECMO initiation and therefore define a future patient population that can benefit from this life-saving procedure. Drs. Fan and Brochard will also perform cost-effective analysis to help individual hospitals determine the feasibility of establishing their own ECMO program. The study will utilize a pre-established online/electronic database for critically ill patients, called the Toronto Intensive Care Observational Registry (iCORE) project. iCORE has already allowed Dr. Fan to answer several clinical questions about critically ill patients, such as what are the barriers to recovery after a patient is intubated (mechanically ventilated) and what are the safest ventilator settings for patients when off sedation.
Hearts of ECMO funding will be dedicated to hiring additional Research Assistants to collect the patient data and for advanced statistical support. Drs. Fan and Brochard envision tangible results within 12-18 months. Without the Research Assistants, the study would be unable to proceed.
Moving forward, Dr. Fan, Dr. Brochard, and the rest of the International ECMO Network would like to extend this research to institutions around the world. This would help create an ECMONet registry, which would be a larger database that could lead to many more life-saving studies.
2. Pharmacokinetics of Sedatives in ECMO Patients Study
While there have been many advances in ECMO technology and its ability to save the lives of critically ill patients, there are still major questions that researchers and clinicians face. Pharmacokinetics, or what happens to a drug once it’s administered to a patient receiving ECMO, is one of the most pressing issues. Because ECMO alters the levels of drugs in the blood, sometimes drastically, and often unpredictably, research in this area is crucial to safely care for ECMO patients.
Dr. Amy Dzierba, Clinical Pharmacist in the Medical Intensive Care Unit at NewYork-Presbyterian, has extensive expertise in treating patients at the bedside receiving ECMO. Dr. Dzierba, who has been asked to speak at national conferences on the appropriate dosing and clinical considerations of medications received during ECMO, is also part of a research team at NewYork-Presbyterian that is focused on unlocking some of the mysteries of ECMO treatment, optimizing the care of these incredibly complex patients. Without the generous support from Hearts of ECMO, critical materials for drawing and transferring the blood samples, laboratory support, and data analysis, would not have been possible or made available.
3. In/Ex Vivo Rodent Lung Perfusion Study
Working with the Center for Acute Respiratory Failure’s Medical ECMO program, researchers at NewYork-Presbyterian/Columbia University Medical Center have been leaders in finding better methods to approach irreversible lung damage. To further this effort, the Hospital and University supported the recruitment of Dr. Valerio Dorrello, an expert in pulmonary critical care, and a scientist with exceptional credentials in this field.
Hearts of ECMO has provided a portion of the funding for Dr. Dorrello, in order to facilitate his groundbreaking research into a complex ex vivo bioreactor that simulates the ventilation and circulation of the lung in a rodent model. A team of multidisciplinary clinicians and engineers, combined with state-of-the-art ECMO technology, gives NewYork-Presbyterian the distinct advantage in conducting this research and applying new and better ways to provide ECMO and lung replacement therapies to treat people with severe pulmonary disease.