The impact of CRRT modality in patients with AKI receiving ECMO: A nationwide registry study in Taiwan
| Autor: | Shao-Wei Chen, Ming-Jen Chan, Cheng-Chia Lee, Ji-Tseng Fang, Chih-Hsiang Chang, Tsung-Yu Tsai, Pei-Chun Fan, Ya-Lien Cheng, Su-Wei Chang, Hsiang-Hao Hsu |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Continuous Renal Replacement Therapy medicine.medical_treatment Taiwan Critical Care and Intensive Care Medicine Lower risk 03 medical and health sciences Young Adult 0302 clinical medicine Extracorporeal Membrane Oxygenation Extracorporeal membrane oxygenation medicine Odds Ratio Humans In patient Renal replacement therapy Hospital Mortality Registries Aged Inflammation business.industry Acute kidney injury 030208 emergency & critical care medicine Odds ratio Acute Kidney Injury Middle Aged medicine.disease Confidence interval Treatment Outcome 030228 respiratory system Propensity score matching Emergency medicine Female Hemofiltration business |
| Zdroj: | Journal of critical care. 57 |
| ISSN: | 1557-8615 |
| Popis: | Purpose Patients receiving extracorporeal membrane oxygenation (ECMO) commonly develop acute kidney injury (AKI) and frequently require continuous renal replacement therapy (CRRT). The impact of different CRRT modalities on survival in patients receiving ECMO remains unclear. Materials and methods Using claims data from Taiwan's National Health Insurance Research Database, a total of 1077 patients who received ECMO and either continuous venovenous hemofiltration (CVVH) or continuous venovenous hemodialysis (CVVHD) for AKI were identified. Inverse probability of treatment weighting was applied using propensity scores to balance the baseline covariates of the two groups. The primary outcome was in-hospital morality. Results We identified 1077 patients (mean age 57.9; 71.8% men). Postcardiotomy shock (49.2%) was the most frequently reported indication for ECMO. The CVVH group had a lower risk of in-hospital mortality (68.4% vs. 76.9%; odds ratio 0.65; 95% confidence interval [CI] 0.50–0.85) compared with the CVVHD group. The CVVH group also had a shorter mean ICU stay compared with the CVVHD group (mean difference −4.59 days, 95% CI −9.15 to −0.03 days). Conclusion Our results suggest that compared with CVVHD, CVVH may be associated with a lower risk of in-hospital mortality in patients with AKI who receive ECMO. |
| Databáze: | OpenAIRE |
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