Best Practices in Performing CRRT during ECMO: Workgroup Statements from the Joint Acute Disease Quality Initiative (ADQI) and Extracorporeal Life Support Organization (ELSO) Consensus Conference on ECMO, AKI, Fluid Management and CRRT.

Abstract

Extracorporeal membrane oxygenation (ECMO) is a well-established life support technology. However, among patients receiving ECMO, acute kidney injury (AKI) is common, and a substantial proportion receive concomitant support with renal replacement therapy (RRT). There are several techniques for combining RRT with ECMO in patients, including the use of in-line hemofilters in the ECMO circuit, integrated RRT machine circuits into the ECMO circuit and the use of parallel circuits where ECMO and CRRT are provided by discrete vascular access. Enclosed is a summary of work group findings from the joint Acute Disease Quality Initiative (ADQI) and Extracorporeal Life Support (ELSO) consensus meeting focused on "ECMO, AKI, Fluid Management and CRRT," which identified priorities, knowledge gaps and research opportunities, along with generating key consensus-based statements to guide best practices for performing CRRT during ECMO.