Analysis of the risk factors of acute kidney injury in patients receiving extracorporeal membrane oxygenation .

BACKGROUND: Acute kidney injury (AKI) during extracorporeal membrane oxygenation (ECMO) affects the prognosis of patients. In the present study, we explored the risk factors for AKI through a retrospective analysis of relevant data of patients undergoing ECMO with AKI.

MATERIALS AND METHODS: Retrospective analysis was performed on patients with AKI who were receiving ECMO. Patient data, including preoperative basic conditions, related clinical conditions during ECMO, and complications, were collected. The patients were divided into two groups according to the occurrence of AKI. For the determination of the ECMO-independent risk factors of AKI, risk factors that may affect AKI and those that affected AKI were selected through single-factor analysis and logistic regression analysis, respectively.

RESULTS: Of the 170 cases included in this study, 91 had AKI (53.5%) as indicated by the single-factor analysis results. CPR before ECMO, high lactic acid levels before ECMO, high inotropic equivalents, large amounts of red blood cells, plasma and platelet transfusion, high C-reactive protein levels, high brain natriuretic peptide levels during ECMO, and a long period of ECMO support were all associated with AKI patients. Multiple-factor analysis results revealed that high lactic acid levels before ECMO (OR 2.96, 95% CI (1.38, 6.34); p = 0.005) and high inotropic equivalents during ECMO (OR 3.17, 95% CI (1.52, 6.61); p = 0.002) were independent risk factors of AKI in patients with ECMO.

CONCLUSION: A high incidence of AKI was observed in patients with ECMO, and large doses of positive inotropic drugs and high lactic acid levels were independent risk factors of the disease in patients with ECMO.
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