Review of Extracorporeal Membrane Oxygenation and Dialysis-Based Liver Support Devices for the Use of Nephrologists

Hamdi, Tamim; Palmer, Biff F.

doi:10.1159/000479342

Cited by 18 publications

(18 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[27] ECMO can lead to AKI through exposure to non-self membranes, nonpulsatile renal blood flow, blood shear stress, air and blood embolisms, hemolysis, and organ crosstalk of the heart, lung, and kidney. [10, 13] Nevertheless, it is generally believed that patient-related factors, including hypoperfusion, hypoxemia, systemic inflammation, and nephrotoxic drug use, playing the main role of developing AKI in critically ill patients who receive ECMO. [27–29] Thus, it is not particularly surprising that in this study, heart failure and liver cirrhosis are major risk factors for developing D-AKI in patients who receive ECMO.…”

Section: Discussionmentioning

confidence: 99%

“…[10] The severity of AKI is a strong predictor of adverse outcomes, and mortality is significantly higher in patients with AKI who require RRT. [11–13] Patients with AKI also exhibit long-term risk of developing chronic kidney disease (CKD), end-stage renal disease (ESRD), and death. [14, 15] A composite of renal outcomes, named major adverse kidney events (MAKE), has been endorsed by the National Institute of Diabetes and Digestive and Kidney Diseases clinical trials workgroup and used in recent studies.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study

Chen

Lee

et al. 2019

PLoS ONE

View full text Add to dashboard Cite

BackgroundAcute kidney injury (AKI) is a common complication of extracorporeal membrane oxygenation (ECMO) treatment. The aim of this study was to elucidate the long-term outcomes of adult patients with AKI who receive ECMO.Materials and methodsThe study analyzed encrypted datasets from Taiwan’s National Health Insurance Research Database. The data of 3251 patients who received first-time ECMO treatment between January 1, 2003, and December 31, 2013, were analyzed. Characteristics and outcomes were compared between patients who required dialysis for AKI (D-AKI) and those who did not in order to evaluate the impact of D-AKI on long-term mortality and major adverse kidney events.ResultsOf the 3251 patients, 54.1% had D-AKI. Compared with the patients without D-AKI, those with D-AKI had higher rates of all-cause mortality (52.3% vs. 33.3%; adjusted hazard ratio [aHR] 1.82, 95% confidence interval [CI] 1.53–2.17), chronic kidney disease (13.7% vs. 8.1%; adjusted subdistribution HR [aSHR] 1.66, 95% CI 1.16–2.38), and end-stage renal disease (5.2% vs. 0.5%; aSHR 14.28, 95% CI 4.67–43.62). The long-term mortality of patients who survived more than 90 days after discharge was 22.0% (153/695), 32.3% (91/282), and 50.0% (10/20) in the patients without D-AKI, with recovery D-AKI, and with nonrecovery D-AKI who required long-term dialysis, respectively, demonstrating a significant trend (Pfor trend <0.001).ConclusionAKI is associated with an increased risk of long-term mortality and major adverse kidney events in adult patients who receive ECMO.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study

Chen

Lee

et al. 2019

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…The incidence of acute kidney injury (AKI) has been reported as high as 80% of ECMO patients and is associated with a quadrupled mortality risk [13,34]. Severe fluid Nursing Implications in the ECMO Patient DOI: http://dx.doi.org /10.5772/intechopen.85982 overload is one of the major reasons that renal replacement therapy (RRT) is initiated in this population and is often performed through the ECMO circuit but can also be performed after the pump, which could lower the risk of air embolism not trapped by the oxygenator [34].…”

Section: Renal and Other Intraabdominal Complicationsmentioning

confidence: 99%

“…Severe fluid Nursing Implications in the ECMO Patient DOI: http://dx.doi.org /10.5772/intechopen.85982 overload is one of the major reasons that renal replacement therapy (RRT) is initiated in this population and is often performed through the ECMO circuit but can also be performed after the pump, which could lower the risk of air embolism not trapped by the oxygenator [34]. Fluid overload is independently associated with increased mortality, prolonged LOS, prolonged ventilator time, and prolonged ECMO time [13,34].…”

Section: Renal and Other Intraabdominal Complicationsmentioning

confidence: 99%

Nursing Implications in the ECMO Patient

Botsch¹,

Protain²,

Smith³

et al. 2019

Advances in Extracorporeal Membrane Oxygenation - Volume 3

View full text Add to dashboard Cite

Effective care and positive outcomes of the extracorporeal membrane oxygenation (ECMO) patient necessitate optimal interdisciplinary management from the healthcare team, including expert care from specially trained registered nurses (RNs). It is incumbent upon the RN caring for the ECMO patient to excel in both time management and assessment skills, as this population often demands care delivery at the pinnacle of intensive care unit (ICU) acuity. Astute and nuanced monitoring of neurological status, bleeding risk with potential (often massive) transfusions, poor hemodynamics, and integrity of the ECMO pump itself are only the few specialized areas of focus that must share priority with traditional nursing considerations involving the critically ill, such as prevention of pressure injuries and bloodstream infections. These high-intensity medical foci must be balanced with ethical considerations, as the ultimate goal of returning the patient to their normal life is not always possible. These demands highlight the dynamic proficiency of the RN caring for the ECMO patient. The following chapter will highlight the importance of specialized nursing care in the critically ill patient supported with ECMO.

show abstract

“…It consists of a bloodstream where two filters perform a purification of watersoluble toxins and then a fractional separation of plasma, so that cellular components and macromolecules are separated by albumin and by low-molecular-weight solvents. Then, the autologous albumin solution crosses a neutral resin filter, which has an increased affinity for bile acids, aromatic amino acids, and phenols, and also an anion exchange resin filter that removes unconjugated bilirubin [64][65][66].…”

Section: The Prometheus Systemmentioning

confidence: 99%

Poisoning in the Pediatric Intensive Care Unit

Nistor¹,

Frăsinariu²,

Rugină³

et al. 2019

Poisoning in the Modern World - New Tricks for an Old Dog?

View full text Add to dashboard Cite

Poisonings during childhood (both accidental and voluntary) are a common cause of presentation in the emergency departments (EDs) and the pediatric intensive care unit (PICU). The admission to PICU is warranted both for treatment and for continuous monitoring, as sometimes the evolution of a poisoning could be unpredictable. Sometimes, complications arise that may prolong the patients' hospitalization and may contribute to lowering the survival rate. The staff in these departments must be well trained to ensure patient monitoring, early detection of complications, and rapid intervention. Supporting vital functions is the main objective of the management of a poisoned patient admitted in PICU. In recent years, staff competence and advanced medical technology have helped to improve the prognosis of the patients admitted to these departments, including of the poisoned patients.

show abstract

Review of Extracorporeal Membrane Oxygenation and Dialysis-Based Liver Support Devices for the Use of Nephrologists

Cited by 18 publications

References 70 publications

Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study

Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: A cohort study

Nursing Implications in the ECMO Patient

Poisoning in the Pediatric Intensive Care Unit

Contact Info

Product

Resources

About