Efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the management of pediatric acute respiratory distress syndrome
BackgroundThe efficacy and safety of combining extracorporeal membrane oxygenation with continuous renal replacement therapy remain controversial. This study aimed to evaluate the efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the tre...
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1556642/full |
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| author | Yufan Yang Yufan Yang Xiangni Wang Xiangni Wang Xiulan Lu Xiulan Lu Xinping Zhang Xinping Zhang Jiaotian Huang Jiaotian Huang Zhenghui Xiao Zhenghui Xiao |
| author_facet | Yufan Yang Yufan Yang Xiangni Wang Xiangni Wang Xiulan Lu Xiulan Lu Xinping Zhang Xinping Zhang Jiaotian Huang Jiaotian Huang Zhenghui Xiao Zhenghui Xiao |
| author_sort | Yufan Yang |
| collection | DOAJ |
| description | BackgroundThe efficacy and safety of combining extracorporeal membrane oxygenation with continuous renal replacement therapy remain controversial. This study aimed to evaluate the efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the treatment of pediatric acute respiratory distress syndrome.MethodsThis retrospective study, conducted at Hunan Children's Hospital between January 2019 and December 2023, included 30 pediatric patients with acute respiratory distress syndrome who underwent extracorporeal membrane oxygenation treatment. The patients were divided into two groups based on whether continuous renal replacement therapy was used during treatment: 21 in the extracorporeal membrane oxygenation with continuous renal replacement therapy group and nine in the extracorporeal membrane oxygenation-only group. The groups were compared using t-test or Wilcoxon rank-sum test.ResultsThis study included 19 (63.3%) male and 11 (36.7%) female patients (mean age: 63.33 ± 54.41 months). The ratios of arterial partial pressure of oxygen to fraction of inspired oxygen before and at withdrawal of extracorporeal membrane oxygenation were 58.50 (40.75–70.31) and 257.00 (113.25–358.33) mmHg, respectively (P < 0.05). In the extracorporeal membrane oxygenation with continuous renal replacement therapy group, 21 patients (70.0%) underwent continuous renal replacement therapy, including those with acute renal injury (n = 5), fluid overload (n = 13), hyperkalemia (n = 3), and removal of inflammatory mediators (n = 3), and improvement was observed.ConclusionsThe combination of extracorporeal membrane oxygenation and continuous renal replacement therapy provides safe and effective respiratory support for pediatric patients with severe acute respiratory distress syndrome and enables effective fluid-balance management, removal of inflammatory factors, and maintenance of electrolyte equilibrium. |
| format | Article |
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| institution | DOAJ |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pediatrics |
| spelling | doaj-art-b7fca59f16564becbe65a6b10b9113752025-08-20T03:01:54ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-03-011310.3389/fped.2025.15566421556642Efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the management of pediatric acute respiratory distress syndromeYufan Yang0Yufan Yang1Xiangni Wang2Xiangni Wang3Xiulan Lu4Xiulan Lu5Xinping Zhang6Xinping Zhang7Jiaotian Huang8Jiaotian Huang9Zhenghui Xiao10Zhenghui Xiao11Department of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, ChinaDepartment of Intensive Care Unit, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha, Hunan, ChinaDepartment of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, ChinaInternal Medicine Teaching and Research Department, Hunan Traditional Chinese Medical College, Zhuzhou, Hunan, ChinaDepartment of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, ChinaDepartment of Intensive Care Unit, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha, Hunan, ChinaDepartment of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, ChinaDepartment of Intensive Care Unit, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha, Hunan, ChinaDepartment of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, ChinaDepartment of Intensive Care Unit, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha, Hunan, ChinaDepartment of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, ChinaDepartment of Intensive Care Unit, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha, Hunan, ChinaBackgroundThe efficacy and safety of combining extracorporeal membrane oxygenation with continuous renal replacement therapy remain controversial. This study aimed to evaluate the efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the treatment of pediatric acute respiratory distress syndrome.MethodsThis retrospective study, conducted at Hunan Children's Hospital between January 2019 and December 2023, included 30 pediatric patients with acute respiratory distress syndrome who underwent extracorporeal membrane oxygenation treatment. The patients were divided into two groups based on whether continuous renal replacement therapy was used during treatment: 21 in the extracorporeal membrane oxygenation with continuous renal replacement therapy group and nine in the extracorporeal membrane oxygenation-only group. The groups were compared using t-test or Wilcoxon rank-sum test.ResultsThis study included 19 (63.3%) male and 11 (36.7%) female patients (mean age: 63.33 ± 54.41 months). The ratios of arterial partial pressure of oxygen to fraction of inspired oxygen before and at withdrawal of extracorporeal membrane oxygenation were 58.50 (40.75–70.31) and 257.00 (113.25–358.33) mmHg, respectively (P < 0.05). In the extracorporeal membrane oxygenation with continuous renal replacement therapy group, 21 patients (70.0%) underwent continuous renal replacement therapy, including those with acute renal injury (n = 5), fluid overload (n = 13), hyperkalemia (n = 3), and removal of inflammatory mediators (n = 3), and improvement was observed.ConclusionsThe combination of extracorporeal membrane oxygenation and continuous renal replacement therapy provides safe and effective respiratory support for pediatric patients with severe acute respiratory distress syndrome and enables effective fluid-balance management, removal of inflammatory factors, and maintenance of electrolyte equilibrium.https://www.frontiersin.org/articles/10.3389/fped.2025.1556642/fullacute respiratory distress syndromecontinuous renal replacement therapyextracorporeal membrane oxygenationpediatricsPICU (pediatric intensive care unit) |
| spellingShingle | Yufan Yang Yufan Yang Xiangni Wang Xiangni Wang Xiulan Lu Xiulan Lu Xinping Zhang Xinping Zhang Jiaotian Huang Jiaotian Huang Zhenghui Xiao Zhenghui Xiao Efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the management of pediatric acute respiratory distress syndrome Frontiers in Pediatrics acute respiratory distress syndrome continuous renal replacement therapy extracorporeal membrane oxygenation pediatrics PICU (pediatric intensive care unit) |
| title | Efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the management of pediatric acute respiratory distress syndrome |
| title_full | Efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the management of pediatric acute respiratory distress syndrome |
| title_fullStr | Efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the management of pediatric acute respiratory distress syndrome |
| title_full_unstemmed | Efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the management of pediatric acute respiratory distress syndrome |
| title_short | Efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the management of pediatric acute respiratory distress syndrome |
| title_sort | efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the management of pediatric acute respiratory distress syndrome |
| topic | acute respiratory distress syndrome continuous renal replacement therapy extracorporeal membrane oxygenation pediatrics PICU (pediatric intensive care unit) |
| url | https://www.frontiersin.org/articles/10.3389/fped.2025.1556642/full |
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