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When CRRT on ECMO Is Not Enough for Potassium Clearance: A Case Report

BACKGROUND: Continuous renal replacement therapy (CRRT) is an excellent method used to remove fluid and solutes. It may also reduce the systemic inflammatory response for patients on extracorporeal membrane oxygenation (ECMO) support. The objective of this report is to describe a case where CRRT in...

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Autores principales: Tijssen, Janice A., Filler, Guido
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5570114/
https://www.ncbi.nlm.nih.gov/pubmed/28856008
http://dx.doi.org/10.1177/2054358117722559
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author Tijssen, Janice A.
Filler, Guido
author_facet Tijssen, Janice A.
Filler, Guido
author_sort Tijssen, Janice A.
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description BACKGROUND: Continuous renal replacement therapy (CRRT) is an excellent method used to remove fluid and solutes. It may also reduce the systemic inflammatory response for patients on extracorporeal membrane oxygenation (ECMO) support. The objective of this report is to describe a case where CRRT in combination with ECMO was insufficient to control hyperkalemia. METHODS: We report the case of an adolescent patient with refractory symptomatic hyperkalemia due to substantial rhabdomyolysis in which CRRT insufficiently cleared the patient’s excess potassium. RESULTS: Intermittent hemodialysis (IHD) was added and proved successful. The patient was weaned off ECMO, CRRT, and IHD, and his cardiac and renal function eventually normalized. CONCLUSIONS: Two important lessons can be learned from this case report: (1) If CRRT is insufficient in achieving a desirable potassium balance, additional IHD should be considered and (2) separate IHD access should be considered to improve efficacy.
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spelling pubmed-55701142017-08-30 When CRRT on ECMO Is Not Enough for Potassium Clearance: A Case Report Tijssen, Janice A. Filler, Guido Can J Kidney Health Dis Original Research Article BACKGROUND: Continuous renal replacement therapy (CRRT) is an excellent method used to remove fluid and solutes. It may also reduce the systemic inflammatory response for patients on extracorporeal membrane oxygenation (ECMO) support. The objective of this report is to describe a case where CRRT in combination with ECMO was insufficient to control hyperkalemia. METHODS: We report the case of an adolescent patient with refractory symptomatic hyperkalemia due to substantial rhabdomyolysis in which CRRT insufficiently cleared the patient’s excess potassium. RESULTS: Intermittent hemodialysis (IHD) was added and proved successful. The patient was weaned off ECMO, CRRT, and IHD, and his cardiac and renal function eventually normalized. CONCLUSIONS: Two important lessons can be learned from this case report: (1) If CRRT is insufficient in achieving a desirable potassium balance, additional IHD should be considered and (2) separate IHD access should be considered to improve efficacy. SAGE Publications 2017-08-21 /pmc/articles/PMC5570114/ /pubmed/28856008 http://dx.doi.org/10.1177/2054358117722559 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research Article
Tijssen, Janice A.
Filler, Guido
When CRRT on ECMO Is Not Enough for Potassium Clearance: A Case Report
title When CRRT on ECMO Is Not Enough for Potassium Clearance: A Case Report
title_full When CRRT on ECMO Is Not Enough for Potassium Clearance: A Case Report
title_fullStr When CRRT on ECMO Is Not Enough for Potassium Clearance: A Case Report
title_full_unstemmed When CRRT on ECMO Is Not Enough for Potassium Clearance: A Case Report
title_short When CRRT on ECMO Is Not Enough for Potassium Clearance: A Case Report
title_sort when crrt on ecmo is not enough for potassium clearance: a case report
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5570114/
https://www.ncbi.nlm.nih.gov/pubmed/28856008
http://dx.doi.org/10.1177/2054358117722559
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