Predictive factors of renal replacement therapy in patients with extracorporeal membrane oxygenation
10.3760/cma.j.issn.1671-0282.2020.02.0019
- VernacularTitle:体外膜肺氧合患者肾脏替代治疗的预测因素分析
- Author:
Huazhong ZHANG
1
;
Xufeng CHEN
;
Jinsong ZHANG
;
Yong MEI
;
Jinru LV
;
Deliang HU
;
Gang ZHANG
;
Wei LI
;
Feng SUN
;
Yuan GUO
;
Jinxia CAI
;
Xihua HUANG
;
Hui ZHANG
;
Weiwei WANG
Author Information
1. 南京医科大学第一附属医院急诊医学中心，南京 210029
- From:
Chinese Journal of Emergency Medicine
2020;29(2):222-226
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the predictive factors of renal replacement therapy (RRT) in extracorporeal membrane oxygenation (ECMO) patients.Methods:The clinical data of 68 ECMO patients treated at Emergence Department of Jiangsu Provincial Hospital from January 2015 to December 2018 were retrospectively analyzed. Vasoactive-inotropic score (VIS) was used to assess the usage of vasoactive-inotropic drugs on day 1, 2 and 3 of ECMO (24 h VIS, 48 h VIS, and 72 h VIS). According to received RRT or not, patients were divided into the RRT group and non-RRT group. Age, gender, weight, VIS, presence of cardiac arrest before ECMO, ECMO mode, and ECMO treatment time were compared. Logistic regression analysis was used to identify predictive factors for RRT in ECMO patients.Results:Of the enrolled patients, 73.5% of ECMO patients received RRT. The mean age, 24 h VIS, ECMO failure and mortality of the RRT group were significantly higher than those of the non-RRT group ( P <0.05). The use of RRT was 87.8% in elderly ECMO patients (> cutoff age of 38.5 years). According to the cutoff value of 24 h VIS (33.75), ECMO patients were divided into the high VIS group and low VIS group. The rates of RRT and mortality were both exceeded 90% in the high VIS group, which was significantly higher than that of the low VIS group ( P <0.05). Logistic regression analysis showed that age ( OR=1.223) and 24 h VIS ( OR=1.033) were predictive factors of RRT in ECMO patients ( P <0.05). Conclusions:Age and 24 h VIS show the predictive value for RRT in ECMO patients.
