The method and challenge of combining extracorporeal membrane oxygenation and continuous renal replacement therapy
10.3760/cma.j.issn.1673-4912.2018.05.001
- VernacularTitle:体外膜肺氧合下连续性肾替代治疗的难点和对策
- Author:
Huijie MIAO
1
;
Yucai ZHANG
Author Information
1. 200062,上海市儿童医院 上海交通大学附属儿童医院重症医学科
- Keywords:
Extracorporeal membrane oxygenation;
Acute kidney injury;
Fluid overload;
Continuous renal replacement therapy
- From:
Chinese Pediatric Emergency Medicine
2018;25(5):321-325
- CountryChina
- Language:Chinese
-
Abstract:
Critical ill with cardiac and respiratory failure receiving extracorporeal membrane oxygenation ( ECMO ) often have comorbid of acute kidney injury and fluid overload. Continuous renal replacement therapy ( CRRT) is required. A variety of methods for combining ECMO and CRRT can be chosen. There are three major ways:performing CRRT through independent venous accessin-line connection ( connection of the hemofilter alone to the ECMO circuit ) , and a CRRT device connected to the ECMO circuit. The combination of ECMO and CRRT appears to be a safe and effective technique. The technique difficulties in concurrent extracorporeal life support system include CRRT device connection ways with ECMO by measuring intra-circuit pressure, anticoagulant use and monitoring access-related complications. The most important management is the CRRT inlet and outlet pressures deviating from the safety range at high ECMO circuit.
