Impact of CRRT in Patients with PARDS Treated with VV-ECMO.

Autor: Redant S; Departments of Intensive Care, Brugmann University Hospital, 1020 Brussels, Belgium.; Departments of Intensive Care, Hospital Universitaire des Enfants Reine Fabiola (HUDERF), 1020 Brussels, Belgium., Barbance O; Departments of Intensive Care, Brugmann University Hospital, 1020 Brussels, Belgium.; Departments of Intensive Care, Hospital Universitaire des Enfants Reine Fabiola (HUDERF), 1020 Brussels, Belgium., Tolwani A; Division of Nephrology, University of Alabama at Birmingham School of Medicine, Birmingham, AL 35233, USA., Beretta-Piccoli X; Departments of Intensive Care, Hospital Universitaire des Enfants Reine Fabiola (HUDERF), 1020 Brussels, Belgium., Massaut J; Departments of Intensive Care, Brugmann University Hospital, 1020 Brussels, Belgium., De Bels D; Departments of Intensive Care, Brugmann University Hospital, 1020 Brussels, Belgium., Taccone FS; Department of Intensive Care, Hopital Erasme, Université Libre de Bruxelles, 1020 Brussels, Belgium., Honoré PM; Departments of Intensive Care, Brugmann University Hospital, 1020 Brussels, Belgium., Biarent D; Departments of Intensive Care, Hospital Universitaire des Enfants Reine Fabiola (HUDERF), 1020 Brussels, Belgium.
Jazyk: angličtina
Zdroj: Membranes [Membranes (Basel)] 2021 Mar 11; Vol. 11 (3). Date of Electronic Publication: 2021 Mar 11.
DOI: 10.3390/membranes11030195
Abstrakt: The high mortality of pediatric acute respiratory distress syndrome (PARDS) is partly related to fluid overload. Extracorporeal membrane oxygenation (ECMO) is used to treat pediatric patients with severe PARDS, but can result in acute kidney injury (AKI) and worsening fluid overload. The objective of this study was to determine whether the addition of CRRT to ECMO in patients with PARDS is associated with increased mortality.
Methods: We conducted a retrospective 7-year study of patients with PARDS requiring ECMO and divided them into those requiring CRRT and those not requiring CRRT. We calculated severity of illness scores, the amount of blood products administered to both groups, and determined the impact of CRRT on mortality and morbidity.
Results: We found no significant difference in severity of illness scores except the vasoactive inotropic score (VIS, 45 ± 71 vs. 139 ± 251, p = 0.042), which was significantly elevated during the initiation and the first three days of ECMO. CRRT was associated with an increase in the use of blood products and noradrenaline ( p < 0.01) without changing ECMO duration, length of PICU stay or mortality.
Conclusion: The addition of CRRT to ECMO is associated with a greater consumption of blood products but no increase in mortality.
Databáze: MEDLINE
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