Abstract: TH-PO049
A Comparison Among Adult Patients Receiving Extracorporeal Membrane Oxygenation With and Without Continuous Renal Replacement Therapy at an Integrated Healthcare System
Session Information
- AKI: Biomarkers, Risk Factors, Treatments, Outcomes
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical‚ Outcomes‚ and Trials
Authors
- Zafar, Waleed, Geisinger Health, Danville, Pennsylvania, United States
- Gajkowski, Evan, Geisinger Health, Danville, Pennsylvania, United States
- Solanki, Kaushal V., Geisinger Health, Danville, Pennsylvania, United States
- Chang, Alex R., Geisinger Health, Danville, Pennsylvania, United States
- Bermudez, Maria, Geisinger Health, Danville, Pennsylvania, United States
Background
Extracorporeal Membrane Oxygenation (ECMO) is being increasingly used among critically ill patients some of whom have multiple organ failure and need concurrent use of continuous renal replacement therapy (CRRT). Limited data are available regarding outcomes among such patients.
Methods
We report retrospective data on patients who were treated with ECMO with or without CRRT over a period of 36 months (Jan 2019 – Mar 2022) at hospitals within a single integrated healthcare system in Pennsylvania. Patients with end stage renal disease were not eligible to receive ECMO within this system.
Results
166 patients were treated with ECMO of whom 50 (30.1%) received CRRT during the course of their treatment. Mean age of patients on ECMO was 52.1 years (interquartile range 43-64), 68.1% were male; and 23.5% had Covid-19. Reasons for ECMO included cardiac arrest (43%), post cardiac surgery (18%), acute respiratory distress syndrome (38%) and transcatheter aortic valve placement (2%). Patients received either Venoarterial (VA) ECMO (45.8% patients; mean age 60.0) and its variant extracorporeal cardiopulmonary resuscitation (eCPR) (9.6%; mean age 50.9) or Venovenous (VV) ECMO (44.6%; mean age 44.4). A comparison among patients who needed CRRT versus those who did not is provided in figure 1. 38% patients who received CRRT survived to discharge compared to 62.9% who did not receive CRRT (p=0.003)
Conclusion
Nearly 1 in 3 patients treated with ECMO needed CRRT at some point during their care. Patients who needed CRRT on ECMO were significantly less likely to survive to discharge. Nephrology service was involved in the care of ECMO patients from the beginning in some cases. However, there remains a need for early multi-disciplinary care for critically ill patients requiring ECMO therapy.