A Multicenter International Survey of Renal Supportive Therapy During ECMO: The Kidney Intervention During Extracorporeal Membrane Oxygenation (KIDMO) Group
A Multicenter International Survey of Renal Supportive Therapy During ECMO: The Kidney Intervention During Extracorporeal Membrane Oxygenation (KIDMO) Group
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DOI：
10.1097/mat.0b013e3182579218
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发表时间：
2012-07-01
期刊：
影响因子：
4.2
通讯作者：
Zappitelli, Michael
中科院分区：
文献类型：
--
作者：
Fleming, Geoffrey M.;Askenazi, David J.;Zappitelli, Michael
急性肾损伤和液体超负荷（FO）与危重患者死亡率增加相关，包括体外膜肺氧合（ECMO）支持的患者。除单中心经验外，ECMO 期间肾脏支持治疗 (RST) 的适应症和应用方法在很大程度上是未知的。当前的研究使用调查设计来记录有关 RST 的实践变化，包括适应症、与 ECMO 回路的接口方法以及处方实践。 65 个国际 ECMO 中心 (31%) 回复了有关 ECMO 期间 RST 的在线电子调查。近四分之一的中心 (23%) 报告在 ECMO 期间未使用 RST。在使用该疗法的患者中，主要的治疗模式是对流，包括缓慢连续超滤和连续静脉静脉血液滤过。 RST 的主要适应症是治疗 (43%) 或预防 (16%) FO。据报道，大多数中心提供肾脏病学而非重症监护医学服务，美国中心和非美国中心之间存在显着差异。这项研究的结果确定了 ECMO 期间 RST 的实践存在很大差异，这将为该小组和其他人进一步研究 RST 和 ECMO 接口提供多种重要途径。 ASAIO 杂志 2012 年；58：407-414。
Acute kidney injury and fluid overload (FO) are associated with increased mortality in critically ill patients, including the subset supported with extracorporeal membrane oxygenation (ECMO). The indication for and method of application of renal support therapy (RST) during ECMO is largely unknown beyond single-center experiences. The current study uses a survey design to document practice variation regarding RST, including indication, method of interface with the ECMO circuit, and prescribing practices. Sixty-five international ECMO centers (31%) responded to an online electronic survey regarding RST during ECMO. Nearly a quarter of centers (23%) reported using no RST during ECMO. Among those using the therapy, the predominant mode of therapy applied was convection and included slow continuous ultrafiltration and continuous venovenous hemofiltration. The predominant indication for RST was the treatment (43%) or prevention (16%) of FO. Nephrology rather than critical care medicine is reported as the prescribing service in a majority of centers with a significant difference between US centers and non-US centers. The results of this study identify a wide variation in practice regarding RST during ECMO that will offer multiple important avenues for further research by this group and others regarding the interface of RST and ECMO. ASAIO Journal 2012;58:407-414.