连续性肾脏替代治疗应用于体外膜氧合患者的研究进展

Research progress of continuous renal replacement therapy in patients with extracorporeal membrane oxygenation

体外膜氧合(ECMO)已广泛应用于危重患者的呼吸循环支持,但此类患者常具有发生多器官功能障碍的高风险,包括急性肾损伤(AKI)、液体超负荷(FO)、电解质紊乱、弥散性血管内凝血和神经系统并发症等。连续性肾替代治疗(CRRT)越来越多应用于治疗ECMO患者的AKI和FO,两者联用可以各自发挥其优势,有可能使危重患者从中受益。目前关于CRRT应用于ECMO患者的研究较少且结论存在较大分歧,本文就ECMO与CRRT两者联合应用的最新进展综述如下。

Extracorporeal membrane oxygenation(ECMO)has been widely used for respiratory and circulatory support in critically ill patients,but these patients are often at high risk of multiple organ dysfunction,including acute kidney injury,fluid overload,electrolyte disturbance,disseminated intravascular coagulation,and neurological complications.Continuous renal replacement therapy(CRRT)is increasingly used to treat AKI and FO in patients with ECMO,and the combination can play their respective advantages,potentially benefiting critically ill patients.At present,there are few studies on the application of CRRT in ECMO patients and the conclusions are quite different.This article reviews the latest progress of the combination of ECMO and CRRT.