The complex relationship of extracorporeal membrane oxygenation and acute kidney injury: causation or association?

Kilburn, Daniel J., Shekar, Kiran and Fraser, John F. (2016) The complex relationship of extracorporeal membrane oxygenation and acute kidney injury: causation or association?. BioMed Research International, 2016 . doi:10.1155/2016/1094296


Author Kilburn, Daniel J.
Shekar, Kiran
Fraser, John F.
Title The complex relationship of extracorporeal membrane oxygenation and acute kidney injury: causation or association?
Journal name BioMed Research International   Check publisher's open access policy
ISSN 2314-6141
2314-6133
Publication date 2016
Year available 2016
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1155/2016/1094296
Open Access Status DOI
Volume 2016
Total pages 17
Place of publication New York, NY, United States
Publisher Hindawi Publishing Corporation
Collection year 2017
Language eng
Abstract Extracorporeal membrane oxygenation (ECMO) is a modified cardiopulmonary bypass (CPB) circuit capable of providing prolonged cardiorespiratory support. Recent advancement in ECMO technology has resulted in increased utilisation and clinical application. It can be used as a bridge-to-recovery, bridge-to-bridge, bridge-to-transplant, or bridge-to-decision. ECMO can restitute physiology in critically ill patients, which may minimise the risk of progressive multiorgan dysfunction. Alternatively, iatrogenic complications of ECMO clearly contribute to worse outcomes. These factors affect the risk: benefit ratio of ECMO which ultimately influence commencement/timing of ECMO. The complex interplay of pre-ECMO, ECMO, and post-ECMO pathophysiological processes are responsible for the substantial increased incidence of ECMO-associated acute kidney injury (EAKI). The development of EAKI significantly contributes to morbidity and mortality; however, there is a lack of evidence defining a potential benefit or causative link between ECMO and AKI. This area warrants investigation as further research will delineate the mechanisms involved and subsequent strategies to minimise the risk of EAKI. This review summarizes the current literature of ECMO and AKI, considers the possible benefits and risks of ECMO on renal function, outlines the related pathophysiology, highlights relevant investigative tools, and ultimately suggests an approach for future research into this under investigated area of critical care.
Keyword Acute Kidney Injury
Extracorporeal Membrane Oxygenation (ECMO)
Cardiopulmonary bypass (CPB)
ECMO-associated acute kidney injury (EAKI)
Renal function
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
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