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Cardiogenic - ClinicalTrials.gov

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Last Updated: 10 September 2022

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The Pulmonary Artery Catheter in Cardiogenic Shock Trial

The PACCS trial, a multicenter, random, parallel group, adaptive trial that will explore the possibility that early invasive hemodynamic assessment and ongoing care with a PAC reduces hospital mortality in patients with acutely decompensated heart failure can be delayed or no PAC-guided inspection.

Source link: https://clinicaltrials.gov/ct2/show/NCT05485376


Implementation of a Cardiogenic Shock Team and Clinical Outcomes (INOVA-SHOCK Registry)

As part of the Shock team's investigation, the primary investigator will designate the data points to be included in the database in order to determine correlations between treatment and negative morbidity and mortality risks, as well as monitoring and improving quality of care provided.

Source link: https://clinicaltrials.gov/ct2/show/NCT03378739


Multi-center Collaborative to Enhance Quality and Outcomes in the Management of Cardiogenic Shock

Cardiogenic shock is a hemodynamically complex and morbid disease characterized by acute cardiovascular dysfunction and end organ dysfunction stemming from profoundly impaired myocardial contractility. CS is also multifactorial with etiologies that go beyond acute coronary thrombosis' boundaries, as more than half of cases can be due to acute decompensated heart disease, a heterogenous conglomeration of disease states that are still poorly understood with similarly poor results. Although preliminary short-term results from such a scheme have been encouraging, there are still gaps in knowledge regarding a number of clinical domains in CS care, including: 1 Prognostic validation of intravascular hemodynamics and risk stratification techniques; 2 The use of surgical catheterization tools in this highly mobile and fragile patient population of this highly mobile and vulnerable patient population; and 6 Final and long-term results following the index clinical case include health-related quality of life measures in this highly mobile patient population. This registry will prospectively and retrospectively follow all patients admitted to their respective health care facilities with the primary diagnosis of CS. Information regarding any morbidities acquired during the course of care will also be collected, both in the cardiac intensive care unit CICU and in the post-ICU program.

Source link: https://clinicaltrials.gov/ct2/show/NCT05185492


HIgh Flow Nasal Cannula Versus Noninvasive Ventilation for Acute Cardiogenic PuLmonary Oedema With Acute Respiratory Failure in an ED

Acute cardiogenic pulmonary oedema is the most common cause of acute respiratory distress in patients admitted to an Emergency Department. The European Society of Cardiology has recommended noninvasive ventilation for acute pulmonary oedema with diuretics and nitrite derivatives. A ventilatory aid used in ICU and recently introduced in Emergency Departments is a high-flow nasal cannula heated and humidified oxygen. HFNO reduces the mortality risk in patients with acute hypoxemic respiratory disease hospitalized in an ICU as compared to NIV and standard oxygen therapy. HFNO is shown to be superior to standard oxygen therapy in acute pulmonary oedema, according to some research, and it may have a similar therapeutic effect to NIV. However, there is no study that has compared the tolerance of patients admitted to an acute pulmonary oedema and treated by HFNO or NIV. Patients will be admitted and released in an Emergency Department immediately after admission and consent.

Source link: https://clinicaltrials.gov/ct2/show/NCT04971213


Assessment of ECMO in Acute Myocardial Infarction With Non-reversible Cardiogenic Shock to Halt Organ Failure and Reduce Mortality (ANCHOR)

The ANCHOR trial is therefore intended to determine if VA-ECMO support provided by IABP has resulted in improved outcomes in comparison to optimal medical care alone in patients with AMI and cardiogenic shock. Since new results showed survival up-to-50 percent with ECMO assistance in this setting, an ethical rescue option to VA-ECMO will nevertheless be available to monitor patients with cardiogenic shock refractory to conventional medical care. As compared to optimal medical care alone, early VA-ECMO, coupled with IABP support and optimal medical care could have a determinant effect on patients with acute myocardial infarction exacerbated by cardiogenic shock. Randomization will be possible in centers with extensive experience in the care of AMI and cardiogenic shock, but there is no on-site ECMO team from the nearest ECMO center with the closest ECMO center can establish ECMO within 2 hours after randomization. Physicians at the non-ECMO center will verify that the ECMO team is immediately available and that an ICU/CCU bed is available at the ECMO center before randomization. If the patient is randomized to the ECMO arm, the mobile ECMO retrieval team will come to the center, begin VA-ECMO, and then quickly transport the patient on VA-ECMO to the ECMO center.

Source link: https://clinicaltrials.gov/ct2/show/NCT04184635


REvaSCUlarization StratEgy of Multivessel Coronary Artery Disease for Patients With Acute Myocardial Infarction Complicated by Cardiogenic SHOCK Undergoing Veno-arterial Extracorporeal Membrane Oxygenator: Randomized-Controlled Trial (RESCUE-SHOCK)

To increase overall myocardial perfusion and hemodynamic stability for patients with AMI and CS, the 2013 American College of Cardiology/American Heart Association and the 2017 European Society of Cardiology guidelines recommend considering PCI of severe stenosis in non-IRA during a primary procedure. However, the CULPRIT-SHOCK trial, which is the largest randomized trial in CS, found that the 30-day risk of a composite of death or severe renal impairment leading to renal transplantation therapy was higher in the immediate multi-vessel PCI group than in the culprit lesion-only PCI group. Patients in the CULPRIT-SHOCK trial may have a mild case of CS and few patients were given MCS devices. The most pronounced in patients with non-ST-segment elevation MI and CS were less pronounced in those requiring MCS, according to the CULPRIT-SHOCK trial. In addition, recent reports from the Korea Acute Myocardial Infarction National Health Registry showed that multivessel PCI was at a reduced risk of all-cause mortality than culprit-only PCI, showing a potential benefit of nonculprit lesion revascularization during the index hospitalization on long-term clinical results. Therefore, the latest randomized trial found that immediate multi-vessel PCI for AMI and multi-vessel disease, as opposed to the culprit lesion-only PCI for AMI and multi-vessel disease with a more advanced CS patients who require veno-arterial extracorporeal membrane oxygenator.

Source link: https://clinicaltrials.gov/ct2/show/NCT05527717

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions