Acute kidney injury in adults receiving extracorporeal membrane oxygenation
Extracorporeal membrane oxygenation (ECMO) has been utilized for critically ill patients such as patients with postcardiotomy cardiogenic shock or life-threatening respiratory failure. Acute kidney injury (AKI) that develops during ECMO is associated with a very poor outcome, possibly because of acc...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2014-11-01
|
| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S092966461400151X |
| _version_ | 1818545360970186752 |
|---|---|
| author | Yung-Chang Chen Feng-Chun Tsai Ji-Tseng Fang Chih-Wei Yang |
| author_facet | Yung-Chang Chen Feng-Chun Tsai Ji-Tseng Fang Chih-Wei Yang |
| author_sort | Yung-Chang Chen |
| collection | DOAJ |
| description | Extracorporeal membrane oxygenation (ECMO) has been utilized for critically ill patients such as patients with postcardiotomy cardiogenic shock or life-threatening respiratory failure. Acute kidney injury (AKI) that develops during ECMO is associated with a very poor outcome, possibly because of accumulated extravascular water causing interstitial overload, impaired oxygen transport through tissues, and increased extravascular lung water volume with impaired O2 transport. Increased water is associated with subsequent organ dysfunction, particularly of the heart, lungs, and brain. Based on single-center studies, the incidence of AKI is 70–85% in ECMO patients. Therefore, renal replacement therapy is required in approximately 50% of these patients. This review summarizes three modalities that can be used to introduce renal replacement therapy to patients on ECMO, the pathophysiology of AKI in ECMO, and the impact of AKI on mortality. This review also identifies specific research-focused questions that need to be addressed to predict AKI early and to improve outcomes in this at-risk adult population. |
| first_indexed | 2024-12-12T07:39:17Z |
| format | Article |
| id | doaj.art-24c06a862e314e3bb3b52cf470d6b634 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-12T07:39:17Z |
| publishDate | 2014-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-24c06a862e314e3bb3b52cf470d6b6342022-12-22T00:32:50ZengElsevierJournal of the Formosan Medical Association0929-66462014-11-011131177878510.1016/j.jfma.2014.04.006Acute kidney injury in adults receiving extracorporeal membrane oxygenationYung-Chang Chen0Feng-Chun Tsai1Ji-Tseng Fang2Chih-Wei Yang3Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Taipei, TaiwanChang Gung University College of Medicine, Taipei, TaiwanKidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Taipei, TaiwanKidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Taipei, TaiwanExtracorporeal membrane oxygenation (ECMO) has been utilized for critically ill patients such as patients with postcardiotomy cardiogenic shock or life-threatening respiratory failure. Acute kidney injury (AKI) that develops during ECMO is associated with a very poor outcome, possibly because of accumulated extravascular water causing interstitial overload, impaired oxygen transport through tissues, and increased extravascular lung water volume with impaired O2 transport. Increased water is associated with subsequent organ dysfunction, particularly of the heart, lungs, and brain. Based on single-center studies, the incidence of AKI is 70–85% in ECMO patients. Therefore, renal replacement therapy is required in approximately 50% of these patients. This review summarizes three modalities that can be used to introduce renal replacement therapy to patients on ECMO, the pathophysiology of AKI in ECMO, and the impact of AKI on mortality. This review also identifies specific research-focused questions that need to be addressed to predict AKI early and to improve outcomes in this at-risk adult population.http://www.sciencedirect.com/science/article/pii/S092966461400151Xcardiorenal syndromeintensive care unitoutcome prognosisrenal replacement therapy |
| spellingShingle | Yung-Chang Chen Feng-Chun Tsai Ji-Tseng Fang Chih-Wei Yang Acute kidney injury in adults receiving extracorporeal membrane oxygenation Journal of the Formosan Medical Association cardiorenal syndrome intensive care unit outcome prognosis renal replacement therapy |
| title | Acute kidney injury in adults receiving extracorporeal membrane oxygenation |
| title_full | Acute kidney injury in adults receiving extracorporeal membrane oxygenation |
| title_fullStr | Acute kidney injury in adults receiving extracorporeal membrane oxygenation |
| title_full_unstemmed | Acute kidney injury in adults receiving extracorporeal membrane oxygenation |
| title_short | Acute kidney injury in adults receiving extracorporeal membrane oxygenation |
| title_sort | acute kidney injury in adults receiving extracorporeal membrane oxygenation |
| topic | cardiorenal syndrome intensive care unit outcome prognosis renal replacement therapy |
| url | http://www.sciencedirect.com/science/article/pii/S092966461400151X |
| work_keys_str_mv | AT yungchangchen acutekidneyinjuryinadultsreceivingextracorporealmembraneoxygenation AT fengchuntsai acutekidneyinjuryinadultsreceivingextracorporealmembraneoxygenation AT jitsengfang acutekidneyinjuryinadultsreceivingextracorporealmembraneoxygenation AT chihweiyang acutekidneyinjuryinadultsreceivingextracorporealmembraneoxygenation |