Continuous renal replacement therapy in multiple organ failure

Background. Acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT) is a severe complication in trauma patients. The aim of the study was to assess primary traumatic injuries and secondary organ failures in severe posttraumatic AKI.Methods. Retrospective review of adult trauma patients admitted to the trauma centre at Oslo University Hospital Ullevål. Injury severity score (ISS) was used to assess the severity of primary injuries, and sequential organ failure assessment (SOFA) score was utilized to measure secondary organ failures.Results. Forty-two (8%) of 506 trauma patients admitted to intensive care unit developed AKI treated with CRRT, whereof 40 (95%) suffered blunt trauma mechanisms. Patients had extensive primary organ injuries with median (interquartile range) ISS 36 (27–49). The majority of the patients had respiratory (93% intubated) and cardiovascular (67% with inotropic and/or vasoactive medication) failure within 24 hours after admission. AKI was often part of multiple organ failure, most frequently respiratory and cardiovascular failure, affecting 33 (75%) and 30 (71%) of the patients, respectively.Conclusion. Trauma patients with AKI undergoing CRRT often had severe primary injuries due to blunt trauma. Most of them suffered from secondary multiple organ failure concomitant to AKI.

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Renal replacement therapy for acute kidney injury and multiple organ failure after surgery under cardiopulmonary bypass

Kardiologiya i serdechno-sosudistaya khirurgiya ◽

10.17116/kardio20181105176 ◽

2018 ◽

Vol 11 (5) ◽

pp. 76 ◽

Cited By ~ 1

Author(s):

E. A. Tabakyan ◽

K. V. Mershin ◽

A. A. Margolina ◽

I. V. Burmistrova ◽

N. A. Buldakova ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiopulmonary Bypass ◽

Renal Replacement Therapy ◽

Multiple Organ Failure ◽

Replacement Therapy ◽

Organ Failure ◽

Kidney Injury ◽

Multiple Organ

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Successfully treated necrotizing fasciitis using extracorporeal life support combined with hemoadsorption device and continuous renal replacement therapy

The International Journal of Artificial Organs ◽

10.1177/0391398817752594 ◽

2018 ◽

Vol 41 (3) ◽

pp. 178-182 ◽

Cited By ~ 1

Author(s):

Maroua Eid ◽

Olivier Fouquet ◽

Cédric Darreau ◽

Marc Pierrot ◽

Achille Kouatchet ◽

...

Keyword(s):

Renal Replacement Therapy ◽

Continuous Renal Replacement Therapy ◽

Necrotizing Fasciitis ◽

Replacement Therapy ◽

Organ Failure ◽

Life Support ◽

Extracorporeal Life Support ◽

Blood Parameters ◽

Multiple Organ ◽

Superficial Fascia

Introduction: Necrotizing fasciitis represents a life-threatening infectious condition that causes spreading necrotisis of superficial fascia and subcutaneous cellular tissues. We describe the case of a patient diagnosed with septic and toxic shocks leading to multiple organ failure successfully treated with a combination of extracorporeal life support, continuous renal replacement therapy, and a hemoadsorption device. Methods: A 41-year-old patient presented with necrotizing fasciitis and multi-organ failure. Initial extracorporeal life support therapy was implanted, compensating for systolic failure. Due to acute renal failure that persisted in time, continuous renal replacement therapy was added. Despite these treatments and as a last attempt to control the septic condition, a CytoSorb® hemoadsorption device was installed in parallel to the extracorporeal life support circuit and two sessions were run. Results: During the days following CytoSorb® treatment, hemodynamic stabilization was observed, as well as normalization of lactic acidosis and blood parameters. Conclusion: This case describes the successful use of CytoSorb® with continuous renal replacement therapy and extracorporeal life support in a combined way to overcome a critical phase of septic shock in a young adult patient. This combination of treatments turned out to be efficient for this patient in the context of necrotizing fasciitis.

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