AI Article Synopsis
- Acute Kidney Injury (AKI) is common in patients on ECMO, affecting 53% before and 42% after ECMO support, but its impact on outcomes isn't well understood.
- A study analyzed 329 adult patients on ECMO from 2000 to 2015, identifying factors like age and chronic kidney disease that contribute to post-ECMO AKI and in-hospital mortality.
- Results showed that pre-ECMO AKI and the need for renal replacement therapy post-ECMO are linked to higher mortality, indicating they are crucial predictors of patient survival.
Article Abstract
Purpose: Acute Kidney Injury (AKI) occurs in up to 85% of patients managed by ECMO support. Limited data are available comparing the outcomes among patients who develop AKI before and after ECMO initiation.
Methods: A retrospective longitudinal observational study was performed on all adult patients placed on ECMO from January 2000 to December 2015 at our institution. Longitudinal multivariate logistic regressional analysis was performed to identify the variables that are associated with the outcome measures (post-ECMO AKI and in-hospital mortality).
Results: A total of 329 patients were included in our analysis in which AKI occurred in 176 (53%) and 137 (42%) patients before and after ECMO, respectively. In the multivariate analysis, increasing age, pre-existing chronic kidney disease (CKD), increasing bilirubin, decreasing fibrinogen, and use of LVAD had significant association with post-ECMO AKI. In-hospital mortality was seen in 128 out of 176 (73%) patients in the pre-ECMO AKI group and 32 out of 137 (42%) in the post-ECMO AKI group. In the multivariate analysis, age, interstitial lung disease, pre-ECMO AKI, and post-ECMO RRT requirement were independently associated with mortality.
Conclusion: AKI before ECMO initiation and the need for RRT post-ECMO are independently associated with poor patient survival.
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| http://dx.doi.org/10.1016/j.jcrc.2024.154528 | DOI Listing |
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