Abstract: FR-PO041
Safety and Efficacy of In-Series Continuous Renal Replacement Therapy in Patients on Venoarterial and Venovenous Extracorporeal Membrane Oxygenation
Session Information
- AKI: Clinical Outcomes, Trials
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Author
- Hebert, Christopher, Kidney and Hypertension Associates of Dallas, Dallas, Texas, United States
Background
There is no standardization or consensus on performing continuous renal replacement therapy in patients on extracorporeal membrane oxygenation in the adult population. Given the limited access points available for patients on extracorporeal membrane oxygenation, it has been the practice at our institution to run CRRT in line with ECMO and then transition to a tunneled dialysis catheter at the time of ECMO decannulation.
Methods
We have performed over 600 ECMO cannulations, 268 of which have required dialysis for renal failure and metabolic clearance or primarily for ultrafiltration and volume removal. Of these 268, we performed CRRT in series on 265 of them using the Nxstage System One with both the Maquet Rotaflow as well as Cardiohelp ECMO systems. There are two separate connections used on the rotaflow ECMO circuit, and a single connection in the Cardiohelp system detailed in the images attached.
Results
In 265 patients, we successfully performed well over 1000 dialysis days of treatments in series with ECMO with virtually no complications. Efficacy was determined by adequate control of acid/base abnormalities as well as overall clearance of urea. Volume removal was typically determine by the overall hemodynamics of the patient, but there were no machine or circuit imitations regarding ultrafiltration.
Conclusion
We have found and demonstrated safety and efficacy of in series CRRT with ECMO in the adult population in a large cohort of patients.