title: Outcome of patients on combined extracorporeal membrane oxygenation and continuous renal replacement therapy: a retrospective study.
abstract: BACKGROUND
  Extracorporeal membrane oxygenation (ECMO) is a lifesaving therapy used in the management of cardiopulmonary failure. Continuous renal replacement therapy (CRRT) is often added to the treatment for the correction of fluid and electrolyte imbalance in patients with acute kidney injury. Most of the literature on the use of combined ECMO and CRRT has been on pediatric patients. There are limited outcome data on the use of these combined modalities in adult patients.
  
  
  METHODS
  This is a retrospective analysis of all the patients above the age of 18 years who underwent combined ECMO and CRRT at a tertiary care medical center during the period January 2007 to January 2012. The primary outcomes measured were mortality at one year and renal recovery or dialysis dependence at one month.
  
  
  RESULTS
  A total of 40 patients who were treated concurrently with ECMO and CRRT were identified. The mean age was 47.01 ± 18.29 years. The most common indications for initiation of CRRT were combined fluid overload and electrolyte imbalance. Mortality at one month was (32/40) 80%. Among the 8 survivors (20%), 3 patients required continuation of hemodialysis and 5 patients were independent of dialysis at 30 days.
  
  
  CONCLUSIONS
  Mortality of patients treated with combined ECMO and CRRT is high. Initiation of CRRT in these patients is simply an indicator of severity of illness and fatality. Younger age, higher arterial pH, left ventricular dysfunction and use of VA ECMO are associated with improved survival in these patients.
authors: 1 Department of Nephrology, University of Arizona Medical Center, Tucson, Arizona - USA.
authors: Bijin
authors: B
authors: Thajudeen
authors: Mahmoud
authors: M
authors: Kamel
authors: Cibi
authors: C
authors: Arumugam
authors: Syed Asad
authors: SA
authors: Ali
authors: Santhosh G
authors: SG
authors: John
authors: Edward E
authors: EE
authors: Meister
authors: Jarrod M
authors: JM
authors: Mosier
authors: Yuval
authors: Y
authors: Raz
authors: Machaiah
authors: M
authors: Madhrira
authors: Jess
authors: J
authors: Thompson
authors: Amy N
authors: AN
authors: Sussman
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014883:Water-Electrolyte Imbalance / Q000628:therapy