Impact of CRRT in Patients with PARDS Treated with VV-ECMO
The high mortality of pediatric acute respiratory distress syndrome (PARDS) is partly related to fluid overload. Extracorporeal membrane oxygenation (ECMO) is used to treat pediatric patients with severe PARDS, but can result in acute kidney injury (AKI) and worsening fluid overload. The objective o...
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doaj-784daf5835db47ed90c7099d8845e3c02021-03-12T00:06:01ZengMDPI AGMembranes2077-03752021-03-011119519510.3390/membranes11030195Impact of CRRT in Patients with PARDS Treated with VV-ECMOSébastien Redant0Océane Barbance1Ashita Tolwani2Xavier Beretta-Piccoli3Jacques Massaut4David De Bels5Fabio S. Taccone6Patrick M. Honoré7Dominique Biarent8Departments of Intensive Care, Brugmann University Hospital, 1020 Brussels, BelgiumDepartments of Intensive Care, Brugmann University Hospital, 1020 Brussels, BelgiumDivision of Nephrology, University of Alabama at Birmingham School of Medicine, Birmingham, AL 35233, USADepartments of Intensive Care, Hospital Universitaire des Enfants Reine Fabiola (HUDERF), 1020 Brussels, BelgiumDepartments of Intensive Care, Brugmann University Hospital, 1020 Brussels, BelgiumDepartments of Intensive Care, Brugmann University Hospital, 1020 Brussels, BelgiumDepartment of Intensive Care, Hopital Erasme, Université Libre de Bruxelles, 1020 Brussels, BelgiumDepartments of Intensive Care, Brugmann University Hospital, 1020 Brussels, BelgiumDepartments of Intensive Care, Hospital Universitaire des Enfants Reine Fabiola (HUDERF), 1020 Brussels, BelgiumThe high mortality of pediatric acute respiratory distress syndrome (PARDS) is partly related to fluid overload. Extracorporeal membrane oxygenation (ECMO) is used to treat pediatric patients with severe PARDS, but can result in acute kidney injury (AKI) and worsening fluid overload. The objective of this study was to determine whether the addition of CRRT to ECMO in patients with PARDS is associated with increased mortality. Methods: We conducted a retrospective 7-year study of patients with PARDS requiring ECMO and divided them into those requiring CRRT and those not requiring CRRT. We calculated severity of illness scores, the amount of blood products administered to both groups, and determined the impact of CRRT on mortality and morbidity. Results: We found no significant difference in severity of illness scores except the vasoactive inotropic score (VIS, 45 ± 71 vs. 139 ± 251, <i>p</i> = 0.042), which was significantly elevated during the initiation and the first three days of ECMO. CRRT was associated with an increase in the use of blood products and noradrenaline (<i>p</i> < 0.01) without changing ECMO duration, length of PICU stay or mortality. Conclusion: The addition of CRRT to ECMO is associated with a greater consumption of blood products but no increase in mortality.https://www.mdpi.com/2077-0375/11/3/195ECMOARDSCRRTAKIpediatric |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sébastien Redant Océane Barbance Ashita Tolwani Xavier Beretta-Piccoli Jacques Massaut David De Bels Fabio S. Taccone Patrick M. Honoré Dominique Biarent |
spellingShingle |
Sébastien Redant Océane Barbance Ashita Tolwani Xavier Beretta-Piccoli Jacques Massaut David De Bels Fabio S. Taccone Patrick M. Honoré Dominique Biarent Impact of CRRT in Patients with PARDS Treated with VV-ECMO Membranes ECMO ARDS CRRT AKI pediatric |
author_facet |
Sébastien Redant Océane Barbance Ashita Tolwani Xavier Beretta-Piccoli Jacques Massaut David De Bels Fabio S. Taccone Patrick M. Honoré Dominique Biarent |
author_sort |
Sébastien Redant |
title |
Impact of CRRT in Patients with PARDS Treated with VV-ECMO |
title_short |
Impact of CRRT in Patients with PARDS Treated with VV-ECMO |
title_full |
Impact of CRRT in Patients with PARDS Treated with VV-ECMO |
title_fullStr |
Impact of CRRT in Patients with PARDS Treated with VV-ECMO |
title_full_unstemmed |
Impact of CRRT in Patients with PARDS Treated with VV-ECMO |
title_sort |
impact of crrt in patients with pards treated with vv-ecmo |
publisher |
MDPI AG |
series |
Membranes |
issn |
2077-0375 |
publishDate |
2021-03-01 |
description |
The high mortality of pediatric acute respiratory distress syndrome (PARDS) is partly related to fluid overload. Extracorporeal membrane oxygenation (ECMO) is used to treat pediatric patients with severe PARDS, but can result in acute kidney injury (AKI) and worsening fluid overload. The objective of this study was to determine whether the addition of CRRT to ECMO in patients with PARDS is associated with increased mortality. Methods: We conducted a retrospective 7-year study of patients with PARDS requiring ECMO and divided them into those requiring CRRT and those not requiring CRRT. We calculated severity of illness scores, the amount of blood products administered to both groups, and determined the impact of CRRT on mortality and morbidity. Results: We found no significant difference in severity of illness scores except the vasoactive inotropic score (VIS, 45 ± 71 vs. 139 ± 251, <i>p</i> = 0.042), which was significantly elevated during the initiation and the first three days of ECMO. CRRT was associated with an increase in the use of blood products and noradrenaline (<i>p</i> < 0.01) without changing ECMO duration, length of PICU stay or mortality. Conclusion: The addition of CRRT to ECMO is associated with a greater consumption of blood products but no increase in mortality. |
topic |
ECMO ARDS CRRT AKI pediatric |
url |
https://www.mdpi.com/2077-0375/11/3/195 |
work_keys_str_mv |
AT sebastienredant impactofcrrtinpatientswithpardstreatedwithvvecmo AT oceanebarbance impactofcrrtinpatientswithpardstreatedwithvvecmo AT ashitatolwani impactofcrrtinpatientswithpardstreatedwithvvecmo AT xavierberettapiccoli impactofcrrtinpatientswithpardstreatedwithvvecmo AT jacquesmassaut impactofcrrtinpatientswithpardstreatedwithvvecmo AT daviddebels impactofcrrtinpatientswithpardstreatedwithvvecmo AT fabiostaccone impactofcrrtinpatientswithpardstreatedwithvvecmo AT patrickmhonore impactofcrrtinpatientswithpardstreatedwithvvecmo AT dominiquebiarent impactofcrrtinpatientswithpardstreatedwithvvecmo |
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