Clinical analysis of continuous renal replacement therapy in patients with extracorporeal membrane oxygenation

ObjectiveTo summarize the clinical experience of continuous renal replacement therapy(CRRT) in patients with extracorporeal membrane oxygenation(ECMO).

MethodsThe clinical data of 124 patients who received ECMO support for more than 24 hours were collected and divided into CRRT+ECMO group(n=74) and ECMO group(n=50) according to whether combined with CRRT.Patients with CRRT were divided into CRRT < 7 d group(n=30) and CRRT ≥ 7 d group(n=44) according to the duration of CRRT, and 52 patients with cardiac arrest were divided into CRRT+ECMO group(n=38) and ECMO group(n=14) according to whether they were combined with CRRT or not.According to the duration of CRRT, the patients with cardiac arrest combined with CRRT were divided into two groups: CRRT < 7 d group(n=17) and CRRT ≥7 d group(n=21).The duration of ECMO treatment, invasive mechanical ventilation, hospital stay and discharge survival rate of the two groups were analyzed respectively.

ResultsAmong 124 adult patients, the duration of ECMO treatment and invasive mechanical ventilation in the CRRT + ECMO group was longer than those in the ECMO group, and the discharge survival rate was lower(P < 0.05 to P < 0.01), but there was no significant difference in hospital stay(P>0.05).Compared with CRRT ≥7 d group, ECMO treatment time, invasive mechanical ventilation time and hospital stay in CRRT < 7 d group were shorter, and the discharge survival rate was lower(P < 0.05).Among the patients with cardiac arrest, there was no significant difference in the duration of ECMO treatment, invasive mechanical ventilation and hospital stay between the CRRT+ECMO group and the ECMO group, but the discharge survival rate was lower in the CRRT+ECMO group(P < 0.01), while the ECMO treatment time, invasive mechanical ventilation time and hospital stay in the CRRT < 7 d group were shorter than those in the CRRT ≥7 d group, there was no significant difference in the discharge survival rate(P>0.05).

ConclusionsPatients with ECMO support and CRRT treatment have lower survival rate, which may be related to severe renal injury.For most patients requiring CRRT support, patients with CRRT support for ≥7 d have a higher survival rate, while patients with cardiac arrest have no clear relationship between CRRT duration and survival, which needs to be confirmed by larger sample studies.