<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec id="j_jccm-2021-0006_s_007">
<h3>Introduction</h3>
<p>Patients on extracorporeal membrane oxygenator (ECMO) therapy are critically ill and often develop acute kidney injury (AKI) during hospitalisation. Little is known about the association of exposure to and the effect of the type of ECMO and extent of renal recovery after AKI development.</p>
</sec>
<sec id="j_jccm-2021-0006_s_008">
<h3>Aim of the study</h3>
<p> In patients who developed AKI, renal recovery was characterised as complete, partial or dialysis-dependent at the time of hospital discharge in both the Veno-Arterial (VA) and Veno-Venous (VV) ECMO treatment groups.</p>
</sec>
<sec id="j_jccm-2021-0006_s_009">
<h3>Material and methods</h3>
<p> The study consisted of a single-centre retrospective cohort that includes all adult patients (n=125) who received ECMO treatment at a tertiary academic medical centre between 2015 to 2019. Data on demographics, type of ECMO circuit, comorbidities, exposure to nephrotoxic factors and receipt of renal replacement therapy (RRT) were collected as a part of the analysis. Acute Kidney Injury Network (AKIN) criteria were used for the diagnosis and classification of AKI. Group differences were assessed using Fisher’s exact tests for categorical data and independent t-tests for continuous outcomes.</p>
</sec>
<sec id="j_jccm-2021-0006_s_010">
<h3>Results</h3>
<p> Sixty-four patients received VA ECMO, and 58 received VV ECMO. AKI developed in 58(91%) in the VA ECMO group and 51 (88%) in the VV ECMO group (p=0.77). RRT was prescribed in significantly higher numbers in the VV group 38 (75%) compared to the VA group 27 (47%) (p=0.0035). At the time of discharge, AKI recovery rate in the VA group consisted of 15 (26%) complete recovery and 5 (9%) partial recovery; 1 (2%) remained dialysis-dependent. In the VV group, 22 (43%) had complete recovery (p=0.07), 3(6%) had partial recovery (p=0.72), and 1 (2%) was dialysis-dependent (p>0.99). In-hospital mortality was 64% in the VA group and 49% in the VV group (p=0.13).</p>
</sec>
<sec id="j_jccm-2021-0006_s_011">
<h3>Conclusions</h3>
<p> Renal outcomes in critically ill patients who develop AKI are not associated with the type of ECMO used. This serves as preliminary data for future studies in the area.</p></sec>
</abstract>

Introduction
Patients on extracorporeal membrane oxygenator (ECMO) therapy are critically ill and often develop acute kidney injury (AKI) during hospitalisation. Little is known about the association of exposure to and the effect of the type of ECMO and extent of renal recovery after AKI development.


Aim of the study
 In patients who developed AKI, renal recovery was characterised as complete, partial or dialysis-dependent at the time of hospital discharge in both the Veno-Arterial (VA) and Veno-Venous (VV) ECMO treatment groups.


Material and methods
 The study consisted of a single-centre retrospective cohort that includes all adult patients (n=125) who received ECMO treatment at a tertiary academic medical centre between 2015 to 2019. Data on demographics, type of ECMO circuit, comorbidities, exposure to nephrotoxic factors and receipt of renal replacement therapy (RRT) were collected as a part of the analysis. Acute Kidney Injury Network (AKIN) criteria were used for the diagnosis and classification of AKI. Group differences were assessed using Fisher’s exact tests for categorical data and independent t-tests for continuous outcomes.


Results
 Sixty-four patients received VA ECMO, and 58 received VV ECMO. AKI developed in 58(91%) in the VA ECMO group and 51 (88%) in the VV ECMO group (p=0.77). RRT was prescribed in significantly higher numbers in the VV group 38 (75%) compared to the VA group 27 (47%) (p=0.0035). At the time of discharge, AKI recovery rate in the VA group consisted of 15 (26%) complete recovery and 5 (9%) partial recovery; 1 (2%) remained dialysis-dependent. In the VV group, 22 (43%) had complete recovery (p=0.07), 3(6%) had partial recovery (p=0.72), and 1 (2%) was dialysis-dependent (p>0.99). In-hospital mortality was 64% in the VA group and 49% in the VV group (p=0.13).


Conclusions
 Renal outcomes in critically ill patients who develop AKI are not associated with the type of ECMO used. This serves as preliminary data for future studies in the area.

Renal Recovery in Critically Ill Adult Patients Treated With Veno-Venous or Veno-Arterial Extra Corporeal Membrane Oxygenation: A Retrospective Cohort Analysis

The Journal of Critical Care Medicine

This work is licensed under the Creative Commons Attribution 4.0 International License.

Introduction
Patients on extracorporeal membrane oxygenator (ECMO) therapy are critically ill and often develop acute kidney injury (AKI) during...

Renal Recovery in Critically Ill Adult Patients Treated With Veno-Venous or Veno-Arterial Extra Corporeal Membrane Oxygenation: A Retrospective Cohort Analysis

Article Category: Research Article

Online veröffentlicht: 12. Mai 2021

Seitenbereich: 104 - 112

Eingereicht: 08. Okt. 2020

Akzeptiert: 27. Jan. 2021

DOI: https://doi.org/10.2478/jccm-2021-0006

Schlüsselwörter
extracorporeal membrane oxygenation, acute kidney injury, treatment outcome, renal replacement therapy, intensive care units

© 2021 Braghadheeswar Thyagarajan, Mariana Murea, Deanna N. Jones, Amit K. Saha, Gregory B. Russell, Ashish K. Khanna, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Renal Recovery in Critically Ill Adult Patients Treated With Veno-Venous or Veno-Arterial Extra Corporeal Membrane Oxygenation: A Retrospective Cohort Analysis

Article Category: Research Article

Online veröffentlicht: 12. Mai 2021

Seitenbereich: 104 - 112

Eingereicht: 08. Okt. 2020

Akzeptiert: 27. Jan. 2021

DOI: https://doi.org/10.2478/jccm-2021-0006

Schlüsselwörterextracorporeal membrane oxygenation, acute kidney injury, treatment outcome, renal replacement therapy, intensive care units

© 2021 Braghadheeswar Thyagarajan, Mariana Murea, Deanna N. Jones, Amit K. Saha, Gregory B. Russell, Ashish K. Khanna, published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Schlüsselwörter
extracorporeal membrane oxygenation, acute kidney injury, treatment outcome, renal replacement therapy, intensive care units