小儿体外膜肺氧合中急性肾损伤及连续性肾脏替代治疗的综述
Review of acute kidney injury and continuous renal replacement therapy in pediatric extracorporeal membrane oxygenation.
作者信息
Jenks Christopher, Raman Lakshmi, Dhar Archana
机构信息
Blair E Batson Children's Hospital, Department of Pediatrics, Section of Critical Care, University of Mississippi Medical Center, Jackson, MS USA.
Children's of Dallas, Department of Pediatrics, Section of Critical Care, University of Texas Southwestern Medical Center, Dallas, TX USA.
出版信息
Indian J Thorac Cardiovasc Surg. 2021 Apr;37(Suppl 2):254-260. doi: 10.1007/s12055-020-01071-3. Epub 2020 Nov 23.
PURPOSE
To review the relevant literature of acute kidney injury (AKI) and continuous renal replacement therapy (CRRT) as it relates to pediatric extracorporeal membrane oxygenation (ECMO).
METHODS
Available online relevant literature.
RESULTS
ECMO is a therapeutic modality utilized to support patients with refractory respiratory and/or cardiac failure. AKI and fluid overload (FO) are frequently observed in this patient population. There are multiple modalities that can be utilized for AKI and FO which include the following: diuretics, in-line hemofiltration, and CRRT. There are multiple considerations when using CRRT with ECMO including access, CRRT flows, hemolysis, anticoagulation, and CRRT termination.
CONCLUSION
While each ECMO center has its own set of equipment, experiences, and practices, it is imperative that the international ECMO community continues to work together to provide an evidence-based approach to address the morbidity and mortality associated with AKI and FO.
目的
回顾急性肾损伤（AKI）和持续肾脏替代治疗（CRRT）与小儿体外膜肺氧合（ECMO）相关的文献。
方法
检索在线可得的相关文献。
结果
ECMO是用于支持难治性呼吸和/或心力衰竭患者的一种治疗方式。在这一患者群体中，急性肾损伤和液体超负荷（FO）很常见。有多种可用于急性肾损伤和液体超负荷的方式，包括以下几种：利尿剂、在线血液滤过和持续肾脏替代治疗。在ECMO联合使用CRRT时，有多个需要考虑的因素，包括通路、CRRT血流量、溶血、抗凝和CRRT终止。
结论
虽然每个ECMO中心都有自己的一套设备、经验和做法，但国际ECMO界必须继续共同努力，提供一种基于证据的方法来应对与急性肾损伤和液体超负荷相关的发病率和死亡率。
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