AI Article Synopsis
- The study investigates how VA-ECMO affects early renal recovery in patients with acute kidney injury (AKI) and cardiogenic shock, focusing on those who experienced AKI before ECMO treatment.
- Out of 145 patients, 43% experienced early renal recovery within 7 days of starting VA-ECMO, while 57% did not.
- Factors like use of nephrotoxic antibiotics, fluid balance, the severity of pre-ECMO AKI, and vasoactive-inotropic scores were identified as key indicators influencing the likelihood of early renal recovery.
Article Abstract
Purpose: The impact of VA-ECMO on early renal recovery (within 7 days after ECMO onset) in patients with pre-ECMO acute kidney injury and cardiogenic shock is unknown.
Material And Methods: This retrospective single-center study included adult patients with cardiogenic shock rescued by VA-ECMO and severe AKI occurring before ECMO implantation (pre-ECMO AKI). Patients with early renal recovery (defined as at least a 50% decrease in peak serum creatinine or weaning from renal replacement therapy) were compared to patients without early renal recovery.
Results: During 7 years, 145 patients with severe pre-ECMO AKI were included. Eighty-two patients had no early renal recovery whereas 63 had early renal recovery within 7 days after VA-ECMO onset. The median time to early renal recovery was 4 (3,6) days. Nephrotoxic antibiotics (HR = 0.35 [95% CI, 0.21-0.59], p < 0.001), median fluid balance during the first 7 days of VA-ECMO (HR = 0.77 [95% CI, 0.64-0.93], p = 0.008), pre-ECMO AKI stage 3 (HR = 0.36 [95% CI, 0.20-0.64], p < 0.001) and median vasoactive-inotropic score (HR = 0.99 [95% CI, 0.98,1.00], p = 0.035) were independently associated with no early renal recovery.
Conclusions: Only 43% of patients with severe pre-ECMO AKI had early renal recovery after VA-ECMO initiation.
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| http://dx.doi.org/10.1016/j.jcrc.2023.154368 | DOI Listing |
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