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. 2017 Jun;21(6):355-358.
doi: 10.4103/ijccm.IJCCM_128_17.

Continuous Renal Replacement Therapy Applications on Extracorporeal Membrane Oxygenation Circuit

Affiliations

Continuous Renal Replacement Therapy Applications on Extracorporeal Membrane Oxygenation Circuit

Ayse Filiz Yetimakman et al. Indian J Crit Care Med. 2017 Jun.

Abstract

Background and aims: Continuous venovenous hemofiltration or hemodiafiltration is used frequently in pediatric patients, but experience of continuous renal replacement therapy (CRRT) application on extracorporeal membrane oxygenation (ECMO) circuit is still limited. Among several methods used for applying CRRT on ECMO patients, we aim to share our experience on inclusion of a CRRT device in the ECMO circuit which we believe is easier and safer to apply.

Materials and methods: The data were collected on demographics, outcomes, and details of the treatment of ECMO patients who had CRRT. During the study period of 3 years, venous cannula of ECMO circuit before pump was used for CRRT access for both the filter inlet and outlet of CRRT machine to minimize the thromboembolic complications. The common indication for CRRT was fluid overload.

Results: CRRT was used in 3.68% of a total number of patients admitted and 43% of patients on ECMO. The patients have undergone renal replacement therapy for periods of time ranging between 24 h and 25 days (260 h mean). The survival rate of this group of patients with multiorgan failure was 33%. Renal recovery occurred in all of the survivors. Complications such as electrolyte imbalance, hypothermia, and bradykinin syndrome were easily managed.

Conclusions: Adding a CRRT device on ECMO circuit is a safe and effective technique. The major advantages of this technique are easy to access, applying CRRT without extra anticoagulation process, preventing potential hemodynamic disturbances, and increased clearance of solutes and fluid overload using larger hemofilter.

Keywords: Continuous venovenous hemodiafiltration; continuous venovenous hemofiltration; extracorporeal membrane oxygenation; renal replacement therapy.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Configuration of the system

References

    1. Bartlett RH, Gazzaniga AB, Jefferies MR, Huxtable RF, Haiduc NJ, Fong SW. Extracorporeal membrane oxygenation (ECMO) cardiopulmonary support in infancy. Trans Am Soc Artif Intern Organs. 1976;22:80–93. - PubMed
    1. Bartlett RH, Gazzaniga AB, Fong SW, Jefferies MR, Roohk HV, Haiduc N. Extracorporeal membrane oxygenator support for cardiopulmonary failure. Experience in 28 cases. J Thorac Cardiovasc Surg. 1977;73:375–86. - PubMed
    1. Kramer P, Wigger W, Rieger J, Matthaei D, Scheler F. Arteriovenous haemofiltration: A new and simple method for treatment of over-hydrated patients resistant to diuretics. Klin Wochenschr. 1977;55:1121–2. - PubMed
    1. Garzotto F, Zanella M, Ronco C. The evolution of pediatric continuous renal replacement therapy. Nephron Clin Pract. 2014;127:172–5. - PubMed
    1. Villa G, Katz N, Ronco C. Extracorporeal membrane oxygenation and the kidney. Cardiorenal Med. 2015;6:50–60. - PMC - PubMed

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