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Continuous Renal Replacement Therapy Applications on Extracorporeal Membrane Oxygenation Circuit

BACKGROUND AND AIMS: Continuous venovenous hemofiltration or hemodiafiltration is used frequently in pediatric patients, but experience of continuous renal replacement therapy (CRRT) application on extracorporeal membrane oxygenation (ECMO) circuit is still limited. Among several methods used for ap...

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Autores principales: Yetimakman, Ayse Filiz, Tanyildiz, Murat, Kesici, Selman, Kockuzu, Esra, Bayrakci, Benan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5492737/
https://www.ncbi.nlm.nih.gov/pubmed/28701841
http://dx.doi.org/10.4103/ijccm.IJCCM_128_17
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author Yetimakman, Ayse Filiz
Tanyildiz, Murat
Kesici, Selman
Kockuzu, Esra
Bayrakci, Benan
author_facet Yetimakman, Ayse Filiz
Tanyildiz, Murat
Kesici, Selman
Kockuzu, Esra
Bayrakci, Benan
author_sort Yetimakman, Ayse Filiz
collection PubMed
description BACKGROUND AND AIMS: Continuous venovenous hemofiltration or hemodiafiltration is used frequently in pediatric patients, but experience of continuous renal replacement therapy (CRRT) application on extracorporeal membrane oxygenation (ECMO) circuit is still limited. Among several methods used for applying CRRT on ECMO patients, we aim to share our experience on inclusion of a CRRT device in the ECMO circuit which we believe is easier and safer to apply. MATERIALS AND METHODS: The data were collected on demographics, outcomes, and details of the treatment of ECMO patients who had CRRT. During the study period of 3 years, venous cannula of ECMO circuit before pump was used for CRRT access for both the filter inlet and outlet of CRRT machine to minimize the thromboembolic complications. The common indication for CRRT was fluid overload. RESULTS: CRRT was used in 3.68% of a total number of patients admitted and 43% of patients on ECMO. The patients have undergone renal replacement therapy for periods of time ranging between 24 h and 25 days (260 h mean). The survival rate of this group of patients with multiorgan failure was 33%. Renal recovery occurred in all of the survivors. Complications such as electrolyte imbalance, hypothermia, and bradykinin syndrome were easily managed. CONCLUSIONS: Adding a CRRT device on ECMO circuit is a safe and effective technique. The major advantages of this technique are easy to access, applying CRRT without extra anticoagulation process, preventing potential hemodynamic disturbances, and increased clearance of solutes and fluid overload using larger hemofilter.
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spelling pubmed-54927372017-07-12 Continuous Renal Replacement Therapy Applications on Extracorporeal Membrane Oxygenation Circuit Yetimakman, Ayse Filiz Tanyildiz, Murat Kesici, Selman Kockuzu, Esra Bayrakci, Benan Indian J Crit Care Med Research Article BACKGROUND AND AIMS: Continuous venovenous hemofiltration or hemodiafiltration is used frequently in pediatric patients, but experience of continuous renal replacement therapy (CRRT) application on extracorporeal membrane oxygenation (ECMO) circuit is still limited. Among several methods used for applying CRRT on ECMO patients, we aim to share our experience on inclusion of a CRRT device in the ECMO circuit which we believe is easier and safer to apply. MATERIALS AND METHODS: The data were collected on demographics, outcomes, and details of the treatment of ECMO patients who had CRRT. During the study period of 3 years, venous cannula of ECMO circuit before pump was used for CRRT access for both the filter inlet and outlet of CRRT machine to minimize the thromboembolic complications. The common indication for CRRT was fluid overload. RESULTS: CRRT was used in 3.68% of a total number of patients admitted and 43% of patients on ECMO. The patients have undergone renal replacement therapy for periods of time ranging between 24 h and 25 days (260 h mean). The survival rate of this group of patients with multiorgan failure was 33%. Renal recovery occurred in all of the survivors. Complications such as electrolyte imbalance, hypothermia, and bradykinin syndrome were easily managed. CONCLUSIONS: Adding a CRRT device on ECMO circuit is a safe and effective technique. The major advantages of this technique are easy to access, applying CRRT without extra anticoagulation process, preventing potential hemodynamic disturbances, and increased clearance of solutes and fluid overload using larger hemofilter. Medknow Publications & Media Pvt Ltd 2017-06 /pmc/articles/PMC5492737/ /pubmed/28701841 http://dx.doi.org/10.4103/ijccm.IJCCM_128_17 Text en Copyright: © 2017 Indian Journal of Critical Care Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Research Article
Yetimakman, Ayse Filiz
Tanyildiz, Murat
Kesici, Selman
Kockuzu, Esra
Bayrakci, Benan
Continuous Renal Replacement Therapy Applications on Extracorporeal Membrane Oxygenation Circuit
title Continuous Renal Replacement Therapy Applications on Extracorporeal Membrane Oxygenation Circuit
title_full Continuous Renal Replacement Therapy Applications on Extracorporeal Membrane Oxygenation Circuit
title_fullStr Continuous Renal Replacement Therapy Applications on Extracorporeal Membrane Oxygenation Circuit
title_full_unstemmed Continuous Renal Replacement Therapy Applications on Extracorporeal Membrane Oxygenation Circuit
title_short Continuous Renal Replacement Therapy Applications on Extracorporeal Membrane Oxygenation Circuit
title_sort continuous renal replacement therapy applications on extracorporeal membrane oxygenation circuit
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5492737/
https://www.ncbi.nlm.nih.gov/pubmed/28701841
http://dx.doi.org/10.4103/ijccm.IJCCM_128_17
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