The Effect of Lt to Rt Shunt Using Veno-veno-arterial Extracorporeal Membrane Oxygenation (ECMO) on Coronary Oxygenation in Lung Transplantation Patients

Study Overview
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Brief Summary
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ECMO(Extracorporeal membrane oxygenation) is being essential for cardiopulmonary failure patients. There are two types of ECMO, which is veno-veno (V-V) that can be used in respiratory failure patients and veno-arterial (V-A) that can be used in cardiac failure patients. V-A ECMO can also be used during lung transplantation, substitution of cardiopulmonary bypass, which can show sufficient performance during operation and better postoperative outcome. However, regarding V-A ECMO circulating from femoral vein to femoral artery, there is a pro blem of differential hypoxia which might influence coronary artery and head vessels. In this prospective study, the investigators are planning to put another ECMO catheter into internal jugular vein which takes a role of left to right shunt, to mitigate the hypoxia of coronary artery.

Conditions
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Interstitial Pulmonary Fibrosis ARDS, COPD (Chronic Obstructive Pulmonary Disease), Bronchiectasis, Lymphangioleiomyomatosis, Primary Pulmonary Hypertension, ARDS (Acute Respiratory Distress Syndrome)

Intervention / Treatment
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* Procedure: Veno-veno-arterial ECMO


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1. scheduled for double lung transplantation Exclusion Criteria: patients who have history of coronary artery occlusive disease patients with arrhythmia

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Veno-veno-arterial ECMO group<br> | Procedure: Veno-veno-arterial ECMO<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| arterial blood oxygen partial pressure (PaO2) |  | 5 min after jugular catheter flow 0ml/min | 
| arterial blood oxygen partial pressure (PaO2) |  | 5 min after jugular catheter flow 500 ml/min | 
| arterial blood oxygen partial pressure (PaO2) |  | 5 min after jugular catheter flow 1,000ml/min | 
| arterial blood oxygen partial pressure (PaO2) |  | 5 min after jugular catheter flow 1,500ml/min | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| venous blood oxygen partial pressure (PvO2) |  | 5 min after jugular catheter flow 0ml/min | 
| venous blood oxygen partial pressure (PvO2) |  | 5 min after jugular catheter flow 500 ml/min | 
| venous blood oxygen partial pressure (PvO2) |  | 5 min after jugular catheter flow 1,000ml/min | 
| venous blood oxygen partial pressure (PvO2) |  | 5 min after jugular catheter flow 1,500ml/min |