Renal Recovery in Critically Ill Adult Patients Treated with Veno-Venous Or Veno-Arterial Extra Corporeal Membrane Oxygenation: a Retrospective Cohort Analysis.
acute kidney injury
extracorporeal membrane oxygenation
intensive care units
renal replacement therapy
treatment outcome
Journal
Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures)
ISSN: 2393-1809
Titre abrégé: J Crit Care Med (Targu Mures)
Pays: Poland
ID NLM: 101706934
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
08
10
2020
accepted:
27
01
2021
entrez:
1
11
2021
pubmed:
2
11
2021
medline:
2
11
2021
Statut:
epublish
Résumé
Patients on extracorporeal membrane oxygenator (ECMO) therapy are critically ill and often develop acute kidney injury (AKI) during hospitalisation. Little is known about the association of exposure to and the effect of the type of ECMO and extent of renal recovery after AKI development. In patients who developed AKI, renal recovery was characterised as complete, partial or dialysis-dependent at the time of hospital discharge in both the Veno-Arterial (VA) and Veno-Venous (VV) ECMO treatment groups. The study consisted of a single-centre retrospective cohort that includes all adult patients (n=125) who received ECMO treatment at a tertiary academic medical centre between 2015 to 2019. Data on demographics, type of ECMO circuit, comorbidities, exposure to nephrotoxic factors and receipt of renal replacement therapy (RRT) were collected as a part of the analysis. Acute Kidney Injury Network (AKIN) criteria were used for the diagnosis and classification of AKI. Group differences were assessed using Fisher's exact tests for categorical data and independent t-tests for continuous outcomes. Sixty-four patients received VA ECMO, and 58 received VV ECMO. AKI developed in 58(91%) in the VA ECMO group and 51 (88%) in the VV ECMO group (p=0.77). RRT was prescribed in significantly higher numbers in the VV group 38 (75%) compared to the VA group 27 (47%) (p=0.0035). At the time of discharge, AKI recovery rate in the VA group consisted of 15 (26%) complete recovery and 5 (9%) partial recovery; 1 (2%) remained dialysis-dependent. In the VV group, 22 (43%) had complete recovery (p=0.07), 3(6%) had partial recovery (p=0.72), and 1 (2%) was dialysis-dependent (p>0.99). In-hospital mortality was 64% in the VA group and 49% in the VV group (p=0.13). Renal outcomes in critically ill patients who develop AKI are not associated with the type of ECMO used. This serves as preliminary data for future studies in the area.
Identifiants
pubmed: 34722911
doi: 10.2478/jccm-2021-0006
pii: jccm-2021-0006
pmc: PMC8519359
doi:
Types de publication
Journal Article
Langues
eng
Pagination
104-112Subventions
Organisme : NCATS NIH HHS
ID : KL2 TR001421
Pays : United States
Informations de copyright
© 2021 Braghadheeswar Thyagarajan, Mariana Murea, Deanna N. Jones, Amit K. Saha, Gregory B. Russell, Ashish K. Khanna, published by Sciendo.
Déclaration de conflit d'intérêts
Conflict of interest None to declare.
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