Acute Kidney Injury requiring renal replacement therapy increases mortality in patients undergoing Extracorporeal Membrane Oxygenation therapy. Divisions.

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Presentation transcript:

Acute Kidney Injury requiring renal replacement therapy increases mortality in patients undergoing Extracorporeal Membrane Oxygenation therapy. Divisions of Cardiothoracic Surgery and Cardiology Cedars Sinai Heart Institute Cedars Sinai Medical Center Los Angeles, California Shyamasundar Balasubramanya, MD, Francisco Arabia, MD, Danny Ramzy, MD, Alfredo Trento MD, Jaime Moriguchi MD Jon Kobashigawa MD, Fardad Esmailian MD

BACKGROUND ECMO is increasingly utilized in patients in extremis as a rescue therapy for reversible respiratory or cardiac disease to improve gas exchange ECMO is also being increasingly used as a bridge to VAD or heart transplantation. However, the rate of acute kidney injury and mortality rate continues to remain high and results in excessive mortality among these patients.

METHODS This is a retrospective analysis of all adult patients undergoing ECMO in a tertiary care referral center. All patients undergoing any form of ECMO between January 2010 and August 2012 in our center were reviewed. Data from all the 61 patients (34 male /27 female), mean age 53 years (18-78 years) was obtained by review of the electronic medical records. Follow up data was obtained for 3 months.

RESULTS Three month survival of all patients was 34.42% (21/61) with a mortality rate of 65.57% (40/61). Of the 61 patients who underwent ECMO 27.8 % (17/61) had acute kidney injury (AKI) that required renal replacement therapy (RRT). Survival among patients undergoing RRT was 11.7% (2/17) and among those not undergoing RRT was 43.18% (19/44) (p<0.05)

CONCLUSIONS Acute Kidney Injury (AKI) requiring Renal Replacement Therapy (RRT) in patients in extremis undergoing ECMO contributes to an increase in mortality. Further studies are needed to elucidate the effects of combined ECMO and RRT on overall survival.