The Use of Computed Tomography (CT) to Measure Skeletal Muscle Quantity and Quality in Patients Receiving ECMO

Study Overview
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Brief Summary
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This is a retrospective, observational study and will investigate the clinical predictive value of and change in muscle quantity and quality in critically ill patients with severe respiratory failure requiring veno-venous extracorporeal membrane oxygenation (VV-ECMO).

Detailed Description
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The use of veno-venous extra-corporeal membrane oxygenation (VV-ECMO) for severe respiratory failure - mainly hypoxaemia - has increased over recent years. Similar to the general population in the Intensive Care Unit (ICU), these patients become deconditioned, severely weak (ICU acquired weakness- ICUAW) and require prolonged rehabilitation after disconnection from VV-ECMO. However, data regarding the magnitude of muscle wasting and recovery in this specific group is lacking. Both poor muscle quantity and quality have been found to be a predictor or poor outcome. As all patients receiving VV-ECMO at our hospital will get an initial CT scan of their chest, abdomen and pelvis, these CT scans will be used to measure muscle quantity and quality of different muscle groups of the abdomen at admission and then using any follow-up CT scan performed within 10 days. In addition, the relationship between the loss of muscle over the course of VV-ECMO and perceived recovery of renal function at ICU discharge will be investigated.

Official Title
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The Use of Computed Tomography (CT) to Measure Skeletal Muscle Quantity and Quality in Patients Receiving ECMO

Conditions
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Critical Illness, Muscle Atrophy

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Critically ill patients with Severe Respiratory Failure who required VV-ECMO and had one or more CT scans of their abdomen Exclusion Criteria: Critically ill patients with Severe Respiratory Failure who required VV-ECMO and did not have one or more CT scans of their abdomen Critically ill patients with Severe Respiratory Failure who required VV-ECMO who have a poor quality CT scan not analysable by the software

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| All cause mortality | Using total muscle quantity and quality measured from CT slice of the third lumbar region. | On ECMO (expected to be about 10 days) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of ECMO duration | Using total muscle quantity and quality measured from CT slice of the third lumbar region. | The total duration on ECMO (expected to be an average of 10 days) | 
| Length of ICU admission | Using total muscle quantity and quality measured from CT slice of the third lumbar region. | The total duration of ICU admission (expected to be around 2 weeks) | 
| Length of hospital stay | Using total muscle quantity and quality measured from CT slice of the third lumbar region. | The total duration of hospital admission (expected to be around 28 days) | 
| Length of ventilation | Using total muscle quantity and quality measured from CT slice of the third lumbar region. | Total duration of mechanical ventilation during intensive care unit stay (expected to be around 10 days) | 
| Discharge destination | Using total muscle quantity and quality measured from CT slice of the third lumbar region. | After discharge from hospital (expected to be around 28 days) | 
| Sequential changes in the muscle quantity over time | Using total muscle quantity measured from CT slice of the third lumbar region. | The total duration of ECMO (expected to be around 10 days) | 
| Sequential changes in muscle quality over time | Using total muscle quality measured from CT slice of the third lumbar region. | The total duration of ECMO (expected to be around 10 days) | 
| Relationship between muscle loss and total nutrition received | Using total muscle quantity measured from CT slice of the third lumbar region. | The total duration of ECMO (expected to be around 10 days) | 
| Relationship between muscle loss and rehabilitation goals met | Using total muscle quantity measured from CT slice of the third lumbar region. | The total duration of ECMO (expected to be around 10 days) | 
| All cause mortality | Using total muscle quantity and quality measured from CT slice of the third lumbar region. | Intensive Care Unit Stay (expected to be about 2 weeks) | 
| All cause mortality | Using total muscle quantity and quality measured from CT slice of the third lumbar region. | 6 months post-ICU discharge | 
| All cause mortality | Using total muscle quantity and quality measured from CT slice of the third lumbar region. | Hospital discharge (expected to be about 28 days) |