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Impact of CRRT in Patients with PARDS Treated with VV-ECMO

Sébastien Redant1,2, Océane Barbance1,2, Ashita Tolwani3

  • 1Departments of Intensive Care, Brugmann University Hospital, 1020 Brussels, Belgium.

Membranes
|April 3, 2021
PubMed

Insights

Adding continuous renal replacement therapy (CRRT) to extracorporeal membrane oxygenation (ECMO) for pediatric acute respiratory distress syndrome (PARDS) increases blood product use but does not affect mortality rates in critically ill children.

Area of Science:

  • Pediatric critical care medicine
  • Nephrology
  • Cardiopulmonary support

Background:

  • Pediatric acute respiratory distress syndrome (PARDS) has high mortality, often linked to fluid overload.
  • Extracorporeal membrane oxygenation (ECMO) is a life-support measure for severe PARDS but can exacerbate fluid overload and lead to acute kidney injury (AKI).

Purpose of the Study:

  • To investigate the association between continuous renal replacement therapy (CRRT) and mortality in pediatric patients with PARDS undergoing ECMO.
  • To evaluate the impact of CRRT on morbidity and resource utilization in this patient population.

Main Methods:

  • Retrospective 7-year study of pediatric patients with PARDS requiring ECMO.
  • Comparison of patients who received CRRT versus those who did not.
  • Analysis of severity of illness scores, blood product administration, and outcomes including mortality and morbidity.

Main Results:

  • No significant difference in overall mortality between groups.
  • CRRT was associated with increased use of blood products and noradrenaline.
  • No significant impact on ECMO duration or length of pediatric intensive care unit (PICU) stay.

Conclusions:

  • The addition of CRRT to ECMO in pediatric patients with PARDS is not associated with increased mortality.
  • CRRT use in this setting correlates with higher consumption of blood products.

Keywords:
AKIARDSCRRTECMOpediatric

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