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Full-Course ECMO Strategy for Moderate-to-Severe ARDS
Sponsor: Southeast University, China
Summary
China faces major challenges in the ECMO management of patients with moderate-to-severe ARDS, including substantial heterogeneity in clinical practice, low weaning success rates, and high complication rates. A key underlying reason is the lack of a standardized full-course management pathway that is applicable to real-world clinical practice in China. This study focuses on the construction and evidence-based evaluation of a precision full-course ECMO management pathway for patients with moderate-to-severe ARDS, aiming to address fragmented care processes and delayed quality improvement. The study includes three main components. First, multidisciplinary consensus and evidence-based findings will be integrated to develop a standardized management pathway covering the full chain of assessment, initiation, maintenance, weaning, and rehabilitation. Second, a nationwide multicenter real-world study with a before-and-after design will be conducted to systematically evaluate the clinical effectiveness of this pathway in reducing mortality and complications and improving patient outcomes. Third, a closed-loop dynamic optimization system based on "pathway-data-feedback-improvement" will be established. With the support of an intelligent data platform and multidisciplinary review mechanisms, the pathway will be continuously updated and refined. Through this study, a reproducible, traceable, and evaluable full-course ECMO management strategy is expected to be established. The study will also build a national collaborative research network and support the development of living clinical guidance, promoting the transition of ECMO care in China from experience-based practice toward standardized, homogeneous, and intelligent management, and providing a key technical framework and practical model for improving critical care.
Official title: Establishment and Evaluation of a Full-Course ECMO Management Strategy for Patients With Moderate-to-Severe ARDS
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
500
Start Date
2026-06-16
Completion Date
2030-02-28
Last Updated
2026-07-27
Healthy Volunteers
No
Conditions
Interventions
Full-Course ECMO Management Pathway
The intervention is a standardized full-course ECMO management pathway for patients with moderate-to-severe ARDS. The pathway covers assessment of ECMO indications, ECMO initiation, cannulation and anticoagulation strategies, mechanical ventilation management, hemodynamic and fluid management, infection prevention, analgesia and sedation, nutrition and rehabilitation, complication prevention and management, weaning assessment, discharge, and follow-up. Individualized adjustments are allowed according to patient condition, and pathway deviations will be recorded for quality improvement and subsequent analysis.
Usual Care
Usual care refers to ECMO management provided before implementation of the standardized full-course ECMO management pathway. Clinical decisions are made according to local practice and clinician judgment at each participating center.
Locations (39)
Beijing Anzhen Hospital, Capital Medical University
Beijing, China
The Second Hospital of Jilin University
Changchun, China
West China Tianfu Hospital, Sichuan University
Chengdu, China
The First People's Hospital of Chenzhou
Chenzhou, China
The Second Affiliated Hospital of Dalian Medical University
Dalian, China
Fuzhou University Affiliated Provincial Hospital
Fuzhou, China
The First Affiliated Hospital of Guangzhou Medical University
Guangzhou, China
Affiliated Hangzhou First People's Hospital of Westlake University School of Medicine
Hangzhou, China
The Second Affiliated Hospital of Zhejiang University School of Medicine
Hangzhou, China
The First Affiliated Hospital of Harbin Medical University
Ha’erbin, China
The Second Affiliated Hospital of Harbin Medical University
Ha’erbin, China
Huai'an First People's Hospital
Huai'an, China
Qilu Hospital of Shandong University
Jinan, China
The First People's Hospital of Kunshan
Kunshan, China
The First Hospital of Lanzhou University
Lanzhou, China
The First People's Hospital of Lianyungang
Lianyungang, China
Liuzhou People's Hospital
Liuzhou, China
Jiangsu Province Hospital
Nanjing, China
Nanjing Drum Tower Hospital (The Affiliated Hospital of Nanjing University Medical School)
Nanjing, China
Zhongda Hospital Southeast University
Nanjing, China
The First Affiliated Hospital of Guangxi Medical University
Nanning, China
The People's Hospital of Guangxi Zhuang Autonomous Region
Nanning, China
The Second Affiliated Hospital of Guangxi Medical University
Nanning, China
Affiliated Hospital of Nantong University
Nantong, China
General Hospital of Ningxia Medical University
Ningxiang, China
The Affiliated Hospital of Qinghai University
Qinghai, China
Quzhou People's Hospital
Quzhou, China
Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (SAMS&SPPH, Affiliated Hospital of UESTC)
Sichuan, China
Suining Central Hospital
Suining, China
The First Affiliated Hospital of Soochow University
Suzhou, China
Wuxi People's Hospital
Wuxi, China
The Second Affiliated Hospital of Xi'an Jiaotong University
Xi'an, China
The First Affiliated Hospital of Xiamen University
Xiamen, China
Xinyang Central Hospital
Xinyang, China
The Affiliated Hospital of Xuzhou Medical Universit
Xuzhou, China
Northern Jiangsu People's Hospital
Yangzhou, China
Henan Provincial People's Hospital
Zhengzhou, China
The First Affiliated Hospital of Zhengzhou University
Zhengzhou, China
Zhongshan Hospital of Traditional Chinese Medicine
Zhongshan, China