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...

Full description

Saved in:
Bibliographic Details
Main Authors: Yufan Yang, Xiangni Wang, Xiulan Lu, Xinping Zhang, Jiaotian Huang, Zhenghui Xiao
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1556642/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849773933384957952
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
id doaj-art-b7fca59f16564becbe65a6b10b911375
institution DOAJ
issn 2296-2360
language English
publishDate 2025-03-01
publisher Frontiers Media S.A.
record_format Article
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
work_keys_str_mv AT yufanyang efficacyandsafetyofextracorporealmembraneoxygenationcombinedwithcontinuousrenalreplacementtherapyinthemanagementofpediatricacuterespiratorydistresssyndrome
AT yufanyang efficacyandsafetyofextracorporealmembraneoxygenationcombinedwithcontinuousrenalreplacementtherapyinthemanagementofpediatricacuterespiratorydistresssyndrome
AT xiangniwang efficacyandsafetyofextracorporealmembraneoxygenationcombinedwithcontinuousrenalreplacementtherapyinthemanagementofpediatricacuterespiratorydistresssyndrome
AT xiangniwang efficacyandsafetyofextracorporealmembraneoxygenationcombinedwithcontinuousrenalreplacementtherapyinthemanagementofpediatricacuterespiratorydistresssyndrome
AT xiulanlu efficacyandsafetyofextracorporealmembraneoxygenationcombinedwithcontinuousrenalreplacementtherapyinthemanagementofpediatricacuterespiratorydistresssyndrome
AT xiulanlu efficacyandsafetyofextracorporealmembraneoxygenationcombinedwithcontinuousrenalreplacementtherapyinthemanagementofpediatricacuterespiratorydistresssyndrome
AT xinpingzhang efficacyandsafetyofextracorporealmembraneoxygenationcombinedwithcontinuousrenalreplacementtherapyinthemanagementofpediatricacuterespiratorydistresssyndrome
AT xinpingzhang efficacyandsafetyofextracorporealmembraneoxygenationcombinedwithcontinuousrenalreplacementtherapyinthemanagementofpediatricacuterespiratorydistresssyndrome
AT jiaotianhuang efficacyandsafetyofextracorporealmembraneoxygenationcombinedwithcontinuousrenalreplacementtherapyinthemanagementofpediatricacuterespiratorydistresssyndrome
AT jiaotianhuang efficacyandsafetyofextracorporealmembraneoxygenationcombinedwithcontinuousrenalreplacementtherapyinthemanagementofpediatricacuterespiratorydistresssyndrome
AT zhenghuixiao efficacyandsafetyofextracorporealmembraneoxygenationcombinedwithcontinuousrenalreplacementtherapyinthemanagementofpediatricacuterespiratorydistresssyndrome
AT zhenghuixiao efficacyandsafetyofextracorporealmembraneoxygenationcombinedwithcontinuousrenalreplacementtherapyinthemanagementofpediatricacuterespiratorydistresssyndrome