Abstract
BackgroundExtracorporeal lung assist devices are increasingly used in the intensive care unit setting to improve extracorporeal gas exchange mainly in patients with acute respiratory distress syndrome. ARDS is frequently accompanied by acute kidney injury; however it is so far unknown how the combination of these two conditions affects long term survival of critically ill patients.MethodsIn a retrospective analysis of a tertiary care hospital we evaluated all patients undergoing interventional lung assist (iLA) treatment between January 1st 2005 and December 31st 2009. Data from all 61 patients (31 F/30 M), median age 40 (28 to 52) years were obtained by chart review. Follow up data up to one year were obtained.ResultsOf the 61 patients undergoing iLA membrane ventilator treatment 21 patients had acute kidney injury network (AKIN) stage 3 and were treated by extended dialysis (ED). Twenty-eight day survival of all patients was 33%. While patients without ED showed a 28 day survival of 40%, the survival of patients with ED was only 19%. Patients on ED were not different in respect to age, weight, Horowitz index and underlying disease.ConclusionsAKI requiring ED therapy in patients undergoing iLA treatment increases mortality in ICU patients. Patients in whom iLA was placed as a bridge to lung transplantation and that were successfully transplanted showed the best outcome. Future studies have to clarify whether it is possible to identify patients that truly benefit from the combination of these two extracorporeal treatment methods.
Highlights
Extracorporeal lung assist devices are increasingly used in the intensive care unit setting to improve extracorporeal gas exchange mainly in patients with acute respiratory distress syndrome
The aim of our study was to investigate the effect of acute kidney injury (AKI) on long term mortality of patients treated by interventional lung assist (iLA)
Within two days of iLA insertion 71% (n = 15) of patients ever to become renal replacement therapy (RRT) dependent were on extended dialysis (ED) (Figure 1)
Summary
Extracorporeal lung assist devices are increasingly used in the intensive care unit setting to improve extracorporeal gas exchange mainly in patients with acute respiratory distress syndrome. The high mortality rate of patients with AKI reaches 60% despite considerable improvement of renal replacement therapy (RRT) This fostered the interest on the impact of AKI on distant organ function. In a study by Floerchinger et al 42% of the patients were treated by continuous veno-venous hemofiltration (CVVH) [9] It is unknown, what impact extended dialysis (ED), an increasingly used RRT method in the ICU [10,11], has on long term survival of patients undergoing iLA treatment. It is not known whether the improvement in respiratory acidosis has any impact on renal function in these patients. The potential impact of iLA treatment on renal function was investigated in this single centre retrospective study
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
