No Placebo Group
Every participant receives an active treatment — no one gets a placebo.
Prior Safety Data
This treatment has already been tested in at least one earlier human trial.
Ready to participate?
Review the details below, then apply to join this clinical trial.
At a Glance
Age
0 – 16
Sex
Any
Trial phase
Phase 2
Study type
Interventional
Purpose
Treatment
Participants needed
50 (estimated)
Sponsor
Stanford University · Other
Who this trial is looking for
This trial is looking for children with severe heart failure to test a device called Cardiohelp. Participants will receive support from this device and may be asked to use one of two different blood thinners during their care.
Are You a Good Fit for This Trial?
Rules you outGestationally corrected age less than 37 weeksSevere malnutritionIrreversible renal failureIrreversible hepatic failureIrreversible lung failureStroke in the past 30 days
You may be able to join if
I am between 0 and 16 years old.
I weigh between 2.5 and 80 kilograms.
I am receiving VA-ECMO for primary heart failure using the Cardiohelp system.
This is my first ECMO run during this hospitalization.
My parent or legal guardian has given written informed consent.
You may not be able to join if
I was born prematurely and my corrected age is less than 37 weeks.
I have bleeding issues that prevent me from using anticoagulants.
I have irreversible failure of my kidneys, liver, or lungs.
I had a stroke or am not sure about my neurological status within the last 30 days.
I am severely malnourished.
I am using an ECMO system other than Cardiohelp.
I have goals that focus only on comfort measures.
I cannot start randomization within 30 hours after ECMO cannulation.
Summarized in plain language from this trial's official eligibility criteria.
The full criteria are further down this page — only the research team can
confirm whether you qualify.
Think this trial could be right for you?
Answer three quick questions written from this study's own rules to see if you may qualify. No account needed to find out.
There are two primary goals of this multicenter clinical trial that combines an FDA device trial and a phase II drug trial in the same study cohort. These two goals are to:
1. To evaluate the safety and effectiveness of the Cardiohelp Device for VA-ECMO (heart-lung support) for up to 30 days of support in children with severe heart failure with the goal to support its FDA clearance in children.
2…
There are two primary goals of this multicenter clinical trial that combines an FDA device trial and a phase II drug trial in the same study cohort. These two goals are to:
1. To evaluate the safety and effectiveness of the Cardiohelp Device for VA-ECMO (heart-lung support) for up to 30 days of support in children with severe heart failure with the goal to support its FDA clearance in children.
2. To evaluate heparin versus bivalirudin as the primary blood thinner (anticoagulant) in a randomized trial of children supported with the Cardiohelp ECMO System with the goal to plan a phase III (pivotal) randomized clinical trial
The main questions the Cardiohelp single-arm trial seeks to answer are:
* What is the safety and effectiveness of the Cardiohelp device for pediatric ECMO?
* Should the Cardiohelp device be FDA-cleared for children based on the results of the study?
* What are the optimal performance specifications of the Cardiohelp device in children?
The main questions the blood thinner randomized trial seeks to answer are:
* Which blood thinner is more promising (i.e., more effective and safer) in children on the Cardiohelp device?
* How should a pivotal trial of heparin vs. bivalirudin be designed so it is the most informative and efficient to determine the best blood thinner?
Children who are receiving the Cardiohelp device will be approached and consented to participate if interested. For the Cardiohelp device trial, participants will undergo a standardized data collection to estimate survival to 30 days and the prevalence of serious adverse events like stroke, bleeding, and hemolysis. For the blood thinner randomized trial, participants will be randomized 1:1 to blood thinner strategy to determine which blood thinner has the fewest bleeding and clotting complications.
For the Cardiohelp single-arm trial, participant outcomes will be compared to performance goals (PG) derived from the ECMO literature. For the blood thinner randomized trial, the amount of bleeding and clotting will be measured.
The study is funded by an R01 grant from the FDA's Office of Orphan Product Development (OOPD).
Trial Locations
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Eligibility Criteria
Inclusion Criteria:
1. Age 0 to 16 years of age (i.e., \<17 years)
2. Body weight 2.5 to 80 kilograms
3. VA-ECMO use for primary cardiac failure using the Cardiohelp system.
4. First ECMO run during the current hospitalization
5. Written informed consent from the parent or legally appointed represe…
Inclusion Criteria:
1. Age 0 to 16 years of age (i.e., \<17 years)
2. Body weight 2.5 to 80 kilograms
3. VA-ECMO use for primary cardiac failure using the Cardiohelp system.
4. First ECMO run during the current hospitalization
5. Written informed consent from the parent or legally appointed representative (LAR)
Exclusion Criteria:Children must not meet any of the following exclusion criteria after ECMO cannulation and immediately prior to consent:
1. Gestationally-corrected age \<37 weeks
2. Bleeding or coagulopathy that is a contraindication to anticoagulation
3. Irreversible renal, hepatic or lung failure
4. Stroke or uncertain neurological status within the past 30 days
5. Severely malnourished
6. Use of an ECMO system other than the Cardiohelp
7. VV-ECMO or ECMO for primary respiratory failure
8. Goals of patient to focus on comfort measures only.
9. Failure to separate from cardiopulmonary bypass
10. Allergy or contraindication to receiving UFH or bivalirudin as a primary anticoagulant on ECMO.
11. Patients who are pregnant or breastfeeding.
12. Unable to undergo randomization within 30 hours following ECMO cannulation (randomized cohort only)
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