Intensive Care

This study is a multicenter randomized clinical trial (RCT) in which we will investigate the effect of early/routine Left Ventricular (LV) unloading in the context of Veno-Arterial ExtraCorporeal Membrane Oxygenation (VA ECMO).

REMAP ECMO trial design:

In cases of severe cardiogenic shock (CS), a last-resort treatment called “ExtraCorporeal Membrane Oxygenation (ECMO)” can be initiated which can temporarily replace cardiac function. The use of ECMO remains associated with high rates of complications, weaning failure and mortality (~ 50%) which can be partly explained by a knowledge gap on how to properly manage patients on ECMO support. To address relevant patient management issues, we designed a “Randomized Embedded Multifactorial Adaptive Platform (REMAP)” in the setting of ECMO (REMAP ECMO). A first embedded RCT investigates the effects of routine early LV unloading through intra-aortic balloon pumping (IABP). Erasmus MC initiated this research and coordinates the study across 12 other participating centres throughout the Netherlands. We also include the majority of the patients, making it especially exciting to be part of the Erasmus MC team!

We are looking for a motivated research master’s student to collaborate with us on the practical execution of this multicentre RCT, which includes tasks such as follow-up, data collection, obtaining informed consent, and conducting interim analyses. Together, we will select a relevant sub-question related to ECMO management, perform statistical analyses, and ultimately co-author an article. Additionally, you will have the opportunity to gain clinical experience with VA ECMO by joining the thoracic ICU for several days. Does this research interest you, and would you like to conduct research in the Intensive Care Unit, with links to cardiology?

If so, please contact me at m.p.j.vansteenwijk@erasmusmc.nl  (Myrthe van Steenwijk, PhD student).

BIOMEXIC Study – The Value of Repeated BIOMarker Measurements During a Spontaneous Breathing Trial to Predict Extubation Failure in Mechanically Ventilated Patients in the ICU

With the BIOMEXIC study, we are investigating the value of repeated biomarker measurements during a spontaneous breathing trial (SBT) to predict extubation failure. The SBT is a test to assess whether a patient can be weaned off mechanical ventilation. Despite passing the test, about 20% of ICU patients require re-intubation after extubation. Through blood draws, ultrasound on heart and lungs, and ECGs around the SBT, we aim to better predict which patients will fail, with the goal of optimizing treatment for these patients before they are extubated.

The BIOMEXIC study is a multicenter study involving five hospitals (EMC, Franciscus, Amphia, Groene Hart, and OLVG). The study runs until April 2025. After that, the data will be available, and we can begin analysis and writing.

We are looking for a research master’s student who can support us in executing the study (think follow-up, data collection, and practical learning points involved in conducting a study) and is also interested in performing statistical analyses and writing an article. I will be writing several articles on this study for my PhD. If this topic interests you, we can choose a sub-question together for you to write your article on.

Are you interested in intensive care medicine and its connections with cardiology? Then this project might be for you! For collaboration or more information, please contact c.groenland@erasmusmc.nl (Carline Groenland, PhD student).