Microcirculation monitoring in cardiogenic shock.
Research type
Research Study
Full title
The importance of microcirculatory measurements in cardiogenic shock, through visual flow assessment and biological sampling. An exploratory analysis.
IRAS ID
277673
Contact name
Suveer Singh
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
2 years, 0 months, 5 days
Research summary
International guidelines define shock as a reduction in tissue perfusion of red blood cells. Resuscitation procedures are expected to improve tissue perfusion. However, currently there are no bedside techniques which can quantitatively measure tissue perfusion. The introduction of hand-held vital microscopes uniquely allows the direct visualization of red blood cell perfusion in the microcirculation of the tissues. Together with biological sampling of influential immune cell and endothelial derived molecules, we aim to deeply characterize the microcirculation of patients in cardiogenic shock (CS). As a result, so to understand whether microcirculatory assessment is a valid adjunct to conventional methods of macrocirculation evaluation for cardiovascular performance (e.g. echocardiography or cardiac output monitoring). Furthermore, we aim to better understand the bio-physiological mechanisms underlying successful recovery or not. This will inform us for a better design of a future, more specific, larger observational study on the role of microcirculation in cardiogenic shock patients, and ultimately better predict survival/mortality, or transition to destination therapy like heart transplantation.
At an individual patient level, these investigations propose to assess tissue sublingual microcirculatory measurements in patients with cardiogenic shock and observe whether therapies aimed at support of the cardiovascular failure, i.e. mechanical cardiac support (MCS) such as veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or the Impella device, are successful in supporting or improving tissue perfusion of the microcirculation.REC name
Wales REC 7
REC reference
24/WA/0344
Date of REC Opinion
23 Jan 2025
REC opinion
Further Information Favourable Opinion