The impact of CRRT modality in patients with AKI receiving ECMO: A nationwide registry study in Taiwan

Cheng Chia Lee, Shao Wei Chen, Ya Lien Cheng, Pei Chun Fan, Tsung Yu Tsai, Ming Jen Chan, Su Wei Chang, Hsiang Hao Hsu, Ji Tseng Fang, Chih Hsiang Chang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

9 Scopus citations

Abstract

Purpose: Patients receiving extracorporeal membrane oxygenation (ECMO) commonly develop acute kidney injury (AKI) and frequently require continuous renal replacement therapy (CRRT). The impact of different CRRT modalities on survival in patients receiving ECMO remains unclear. Materials and methods: Using claims data from Taiwan's National Health Insurance Research Database, a total of 1077 patients who received ECMO and either continuous venovenous hemofiltration (CVVH) or continuous venovenous hemodialysis (CVVHD) for AKI were identified. Inverse probability of treatment weighting was applied using propensity scores to balance the baseline covariates of the two groups. The primary outcome was in-hospital morality. Results: We identified 1077 patients (mean age 57.9; 71.8% men). Postcardiotomy shock (49.2%) was the most frequently reported indication for ECMO. The CVVH group had a lower risk of in-hospital mortality (68.4% vs. 76.9%; odds ratio 0.65; 95% confidence interval [CI] 0.50–0.85) compared with the CVVHD group. The CVVH group also had a shorter mean ICU stay compared with the CVVHD group (mean difference −4.59 days, 95% CI −9.15 to −0.03 days). Conclusion: Our results suggest that compared with CVVHD, CVVH may be associated with a lower risk of in-hospital mortality in patients with AKI who receive ECMO.

Original languageEnglish
Pages (from-to)102-107
Number of pages6
JournalJournal of Critical Care
Volume57
DOIs
StatePublished - 06 2020

Bibliographical note

Publisher Copyright:
© 2020 Elsevier Inc.

Keywords

  • Acute kidney injury
  • Continuous renal replacement therapy
  • Extracorporeal membrane oxygenation
  • Mortality

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