The method and challenge of combining extracorporeal membrane oxygenation and continuous renal replacement therapy / 中国小儿急救医学

ABSTRACT

Critical ill with cardiac and respiratory failure receiving extracorporeal membrane oxygenation ( ECMO ) often have comorbid of acute kidney injury and fluid overload. Continuous renal replacement therapy ( CRRT) is required. A variety of methods for combining ECMO and CRRT can be chosen. There are three major ways:performing CRRT through independent venous accessin-line connection ( connection of the hemofilter alone to the ECMO circuit ) , and a CRRT device connected to the ECMO circuit. The combination of ECMO and CRRT appears to be a safe and effective technique. The technique difficulties in concurrent extracorporeal life support system include CRRT device connection ways with ECMO by measuring intra-circuit pressure, anticoagulant use and monitoring access-related complications. The most important management is the CRRT inlet and outlet pressures deviating from the safety range at high ECMO circuit.