ECMO Energy

The measurement of energy expenditure in patients receiving veno-arterial Extracorporeal Membrane Oxygenation (ECMO)

ECMO energy is a single-centre prospective observational study exploring the feasibility of measuring energy expenditure in 30 critically ill adult patients receiving veno-arterial ECMO. It is a collaborative research project between Alfred Health and the ANZIC-RC.

Goals: The primary aim of the study is to assess the feasibility of measuring the energy expenditure of patients receiving veno-arterial ECMO using indirect calorimetry at the native lung, in combination with the quantification of gas exchange at the ECMO membrane to estimate total energy expenditure.

ECMO-Energy logo 

Rationale: Veno-arterialECMO is a specialised cardiorespiratory support for patients with severe heart dysfunction. ECMO supports the circulation via a pump, and gas exchange (oxygen and carbon dioxide) occurs via an external membrane. ECMO patients are vulnerable to both rapid weight loss as well as complications related to overfeeding. Therefore the provision of the correct amount of nutrition is an essential element of care. However, we are currently uncertain of how to accurately determine the energy they require, as gas exchange across the external membrane means current measures are inaccurate. In this study, the feasibility of measuring carbon dioxide production and oxygen consumption across the ECMO membrane as well as the lung will be determined. Exact energy expenditure has not previously been established in veno-arterial ECMO. This study will aim to improve the accuracy of nutrition delivery in this patient group.

Study Progress: Recruitment completed, manuscript published - please see citation below.

Registration: Australian New Zealand Clinical Trials Registry, Trial ID ACTRN12619000760178. Registered 22 May 2019.

Funding: ECMO energy is funded by The Alfred Research Trusts 2019 Small Project Grant.

Publications: 

Tatucu-Babet OA, Diehl A, Kratzing C, Lambell K, Burrell A, Tierney A, Nyulasi I, Bailey M, Sheldrake J, Ridley EJ. Modified indirect calorimetry for patients on venoarterial extracorporeal membrane oxygenation: a pilot feasibility study. Eur J Clin Nutr 2023.  https://pubmed.ncbi.nlm.nih.gov/37198437/; https://doi.org/10.1038/s41430-023-01291-x

Contact: For further information about this study, please contact ANZIC-RC Nutrition Program Manager, Dr Emma Ridley, or Alfred Principal Investigator, Dr Arne Diehl.