Prognosis of Patients on Extracorporeal Membrane Oxygenation: The Impact of Acute Kidney Injury on Mortality

Chen, Yung‐Chang; Tsai, Feng‐Chun; Chang, Chih‐Hsiang; Lin, Chan‐Yu; Jenq, Chang‐Chyi; Juan, Kuo-Chang; Hsu, Hsiang-Hao; Chang, Ming‐Yang; Tian, Ya-Chung; Hung, Cheng‐Chieh; Fang, Ji‐Tseng; Yang, Chih-Wei

doi:10.1016/j.athoracsur.2010.08.063

Cited by 95 publications

(75 citation statements)

References 15 publications

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“…While a number of studies have assessed the ability of previously-verified risk scores to predict mortality in all ECMO patients (both cardiac and respiratory), because the etiologies for ECMO in these two patient groups differ so widely, it is our impression that these two populations must be considered separately. 1,17,18 An organ system-specific score, the MELD score, also showed a poor correlation with cardiac ECMO mortality. This is likely because the MELD score was designed specifically to predict mortality in patients with primary liver failure, but the liver dysfunction in cardiac ECMO patients are more likely secondary to cardiogenic shock.…”

Section: Discussionmentioning

confidence: 99%

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Simple new risk score model for adult cardiac extracorporeal membrane oxygenation: simple cardiac ECMO score

Peigh

Cavarocchi

Keith

et al. 2015

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 99%

“…The literature reports that hospital survival rates after being supported by ECMO range widely from 20% to 65%. 1,2,3,4 Since the indications for ECMO used to support a patient with cardiac or respiratory failure can differ greatly, it is important to consider these two populations as different when doing specific analyses.…”

Section: Introductionmentioning

confidence: 99%

Simple new risk score model for adult cardiac extracorporeal membrane oxygenation: simple cardiac ECMO score

Peigh

Cavarocchi

Keith

et al. 2015

Journal of Surgical Research

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“…Chen et al [13] retrospectively evaluated the outcomes of 102 patients treated with ECMO and identified the relationship between prognosis and AKIN scores obtained at pre-ECMO support (AKIN0-h), and at 24 h (AKIN24-h) and 48 h (AKIN48-h) post-ECMO support. The overall mortality rate was 57.8%.…”

Section: Patients On Extracorporeal Membrane Oxygenationmentioning

confidence: 99%

Acute kidney injury classification: AKIN and RIFLE criteria in critical patients

Lin

Chen

2012

WJCCM

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Acute kidney injury (AKI) is a common and serious complication in critically ill patients. The mortality rate remains high despite improved renal replacement techniques. A possible cause of the high mortality rate is that intensive care unit patients tend to be older and more debilitated than before. Pathophysiological factors associated with AKI are also implicated in the failure of other organs, indicating that AKI is often part of a multiple organ failure syndrome. Until recently, there was a lack of consensus as to the best definition, characterization, and evaluation of acute renal failure. This lack of a standard definition has been a major impediment to progress in clinical and basic research. The introduction of the risk, injury, failure, loss, and end-stage kidney disease criteria and the modified version proposed by the Acute Kidney Injury Network have increased the conceptual understanding of AKI syndrome, and these criteria have been successfully tested in clinical studies. This article reviews current findings concerning the application of these criteria for assessing epidemiology and predicting outcome in specific homogeneous critically ill patient groups.

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“…(13)(14)(15) Several studies (16)(17)(18) showed that AKI is common in critically ill patients using MCS. Oliguria and acute tubular necrosis (ATN) associated with capillary permeability and intravascular volume depletion are frequent during the first 24 to 48 hours of ECMO, due to the acute inflammatory reaction triggered by ECMO.…”

Section: Discussionmentioning

confidence: 99%

Desfechos clínicos de pacientes pediátricos tratados com oxigenação por membrana extracorpórea

et al. 2016

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Objective: To identify factors related to mortality, and evaluate the survival of pediatric patients treated with extracorporeal membrane oxygenation. Methods: A retrospective cohort study that included pediatric patients using the device in the last five years. The groups were divided into those who survived after therapy, and those who did not. Multivariate logistic regression was used for assessing the predictive factors of death, and the Kaplan-Meier and log-rank for assessing survival. Results: Left ventricular ejection fraction was higher in the group of survivors (74% + 14.6% vs 56.2% + 22%, p = 0.038), and the number of patients who required dialysis was higher in the group of non-survivors (52.4% vs. 12.5%, p = 0.039), showing significantly lower survival in this group (log-rank = 0.020). Conclusion: Previous ventricular dysfunction, evidenced by a left ventricular ejection fraction <55%, and requirement of concomitant renal replacement therapy, increased the risk of death. ResumoObjetivo: Identificar os fatores relacionados à mortalidade e avaliar a sobrevida de pacientes pediátricos tratados com oxigenação por membrana extracorpórea. Métodos: Estudo de coorte retrospectivo, que incluiu pacientes pediátricos que utilizaram o dispositivo nos últimos cinco anos. Os grupos foram divididos com base naqueles que sobreviveram ou não após a terapia. Para avaliar os fatores preditivos de morte, foi utilizada análise multivariada com regressão logística e, para a sobrevida, o método de Kaplan-Meier e Log-Rank. Resultados: A fração de ejeção do ventrículo esquerdo era maior no grupo de sobreviventes (74%+14,6% vs 56,2% + 22%, p=0,038) e o número de pacientes que necessitaram de diálise foi maior no grupo de não sobreviventes (52,4% vs. 12,5%, p=0,039), sendo a sobrevida significativamente menor neste grupo (logrank=0,020). Conclusão: Disfunção ventricular prévia, evidenciada pela fração de ejeção do ventrículo esquerdo <55%, e necessidade de terapia de substituição renal concomitante aumentaram o risco de morte.

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Prognosis of Patients on Extracorporeal Membrane Oxygenation: The Impact of Acute Kidney Injury on Mortality

Cited by 95 publications

References 15 publications

Simple new risk score model for adult cardiac extracorporeal membrane oxygenation: simple cardiac ECMO score

Simple new risk score model for adult cardiac extracorporeal membrane oxygenation: simple cardiac ECMO score

Acute kidney injury classification: AKIN and RIFLE criteria in critical patients

Desfechos clínicos de pacientes pediátricos tratados com oxigenação por membrana extracorpórea

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