scholarly journals Clinical Characteristics and Outcomes of Children With Extracorporeal Membrane Oxygenation in a Developing Country: An 11-Year Single-Center Experience

2021 ◽  
Vol 9 ◽  
Author(s):  
Wirapatra Iamwat ◽  
Piya Samankatiwat ◽  
Rojjanee Lertbunrian ◽  
Nattachai Anantasit
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Developing Country ◽  
Enteral Feeding ◽  
Kidney Injury ◽  
Membrane Oxygenation ◽  
Single Center Experience ◽  
Potential Risk Factors ◽  
Poor Outcomes

Introduction: Extracorporeal Membrane Oxygenation (ECMO) is a lifesaving procedure for patients with refractory cardiac or respiratory failure. The indications for ECMO are growing, and it is increasingly being used to support cardiopulmonary failure in children. However, the risks and benefits of ECMO should be weighed before deploying it on the patients. The objectives of this study were to identify the mortality risk factors and to determine the ECMO outcomes.Methods: The retrospective chart reviews were done for all patients aged 1 day−20 years old receiving ECMO between January 2010 and December 2020.Results: Seventy patients were enrolled in the study. The median age was 31.3 months. The incidence of VA and VV ECMO was 85.7 and 14.3%, respectively. The most common indication for ECMO was the failure to wean off cardiopulmonary bypass after cardiac surgery. Pre-existing acute kidney injury (OR 4.23; 95% CI 1.34–13.32, p = 0.014) and delayed enteral feeding (OR 3.85, 95% CI 1.23–12.02, p = 0.020), and coagulopathy (OD 12.64; 95% CI 1.13–141.13, p = 0.039) were associated with the higher rate of mortality. The rates of ECMO survival and survival to discharge were 70 and 50%, respectively.Conclusion: ECMO is the lifesaving tool for critically ill pediatric patients. Pre-existing acute kidney injury, delayed enteral feeding, and coagulopathy were the potential risk factors associated with poor outcomes in children receiving ECMO. However, ECMO setup can be done successfully in a developing country.

scholarly journals Risk Factors for Acute Kidney Injury and In-Hospital Mortality in Patients Receiving Extracorporeal Membrane Oxygenation

PLoS ONE ◽  
2015 ◽  
Vol 10 (10) ◽  
pp. e0140674 ◽  
Author(s):  
Sung Woo Lee ◽  
Mi-yeon Yu ◽  
Hajeong Lee ◽  
Shin Young Ahn ◽  
Sejoong Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Membrane Oxygenation

scholarly journals Risk Factors Analysis of Acute Kidney Injury in Adult Patients Receiving Extracorporeal Membrane Oxygenation

2020 ◽  
Author(s):  
Zhixiang Mou
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Liver Cirrhosis ◽  
Extracorporeal Membrane Oxygenation ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Ecmo Support ◽  
Adult Patients ◽  
Severe Bleeding ◽  
Membrane Oxygenation

AbstractBackgroundAcute kidney injury (AKI) has been reported as one of the most common complication in patients receiving extracorporeal membrane oxygenation (ECMO), the risk factors of AKI on ECMO is unknown. This meta-analysis aimed to find out the risk factors of AKI among adult patients receiving ECMO.MethodsA literature search was performed using PubMed,Web of Science, and Embase fulfilled the pre-specified criteria until April 2020 to include studies reported the necessary clinic characteristics, then the gender, cancer, diffuse intravascular coagulation (DIC), massive/severe Bleeding, intra-aortic balloon pump (IABP), post-cardiotomy, diabetes mellitus, liver cirrhosis and ECMO support duration were pooled for further analysis by STATA to get conclusion.ResultsThis research is first time to provide the evidence that patients developed AKI/severe AKI with a longer ECMO support duration (pooled WMD, 4.09 days; 95% CI: 2.45-5.73 days, Z= 4.89, P= 0.000, I2= 73.4%, χ2P= 0.023/pooled WMD, 1.52 days; 95% CI: 0.19-2.85 days, Z= 2.25, P= 0.025, I2= 77.4%, χ2P= 0.001) and the risk of severe AKI requiring RRT was higher (pooled OR, 2.22; 95% CI: 1.24-3.99, Z= 2.68, P= 0.007, I2= 0.0%, χ2P= 0.634) in liver cirrhosis patients by systemic analysis, indicated ECMO support duration and liver cirrhosis may act as risk factors of AKI in adult patients received ECMO.

Does acute kidney injury affect survival in adults with acute respiratory distress syndrome requiring extracorporeal membrane oxygenation?

Perfusion ◽  
2018 ◽  
Vol 33 (5) ◽  
pp. 375-382 ◽  
Author(s):  
Richard Devasagayaraj ◽  
Nicholas C. Cavarocchi ◽  
Hitoshi Hirose
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Respiratory Distress Syndrome ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Kidney Injury ◽  
Membrane Oxygenation ◽  
Vv Ecmo

Introduction: Patients who develop severe acute respiratory distress syndrome (ARDS) despite full medical management may require veno-venous extracorporeal membrane oxygenation (VV ECMO) to support respiratory function. Survival outcomes remain unclear in those who develop acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) during VV ECMO for isolated severe respiratory failure in adult populations. Methods: A retrospective chart review (2010-2016) of patients who underwent VV ECMO for ARDS was conducted with university institutional review board (IRB) approval. Patients supported by veno-arterial ECMO were excluded. AKI was defined by acute renal failure receiving CRRT and the outcomes of patients on VV ECMO were compared between the AKI and non-AKI groups. Results: We identified 54 ARDS patients supported by VV ECMO (mean ECMO days 12 ± 6.7) with 16 (30%) in the AKI group and 38 (70%) in the non-AKI group. No patient had previous renal failure and the serum creatinine was not significantly different between the two groups at the time of ECMO initiation. The AKI group showed a greater incidence of complications during ECMO, including liver failure (38% vs. 5%, p=0.002) and hemorrhage (94% vs. 45%, p=0.0008). ECMO survival of the AKI group (56% [9/16]) was inferior to the non-AKI group (87% [33/38], p=0.014). Conclusions: Our study demonstrated that VV ECMO successfully manages patients with severe isolated lung injury. However, once patients develop AKI during VV ECMO, they are likely to further develop multi-organ dysfunction, including hepatic and hematological complications, leading to inferior survival.

scholarly journals Acute Kidney Injury, Fluid Overload, and Outcomes in Children Supported With Extracorporeal Membrane Oxygenation for a Respiratory Indication

ASAIO Journal ◽  
2020 ◽  
Vol 66 (3) ◽  
pp. 319-326 ◽  
Author(s):  
Palen P. Mallory ◽  
David T. Selewski ◽  
David J. Askenazi ◽  
David S. Cooper ◽  
Geoffrey M. Fleming ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Fluid Overload ◽  
Kidney Injury ◽  
Membrane Oxygenation

scholarly journals Impact of an inline extracorporeal membrane oxygenation hemofilter system in neonatal acute kidney injury

2018 ◽  
Vol Volume 14 ◽  
pp. 811-816
Author(s):  
Mohammed Azar ◽  
Abdulrahman Alamir ◽  
Abdullah Thabet Al Qahtani ◽  
Khamisa Al Mokali ◽  
Khalid Al Fakeeh
Keyword(s):  
Acute Kidney Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Kidney Injury ◽  
Membrane Oxygenation
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