RESUMO
Mechanical life support therapies exist in many forms to temporarily replace the function of vital organs. Generally speaking, these tools are supportive therapy to allow for organ recovery but, at times, require transition to long-term mechanical support. This review will examine nonrenal extracorporeal life support for cardiac and pulmonary support as well as other mechanical circulatory support options. This is intended as a general primer and overview to assist nephrologist consultants participating in the care of these critically ill patients who often experience acute renal injury as a result of cardiopulmonary shock and from their exposure to mechanical circulatory support.
Assuntos
Injúria Renal Aguda , Oxigenação por Membrana Extracorpórea , Insuficiência Cardíaca , Coração Auxiliar , Injúria Renal Aguda/terapia , Consultores , Estado Terminal , Oxigenação por Membrana Extracorpórea/efeitos adversos , Insuficiência Cardíaca/terapia , HumanosRESUMO
The number of patients using critical care is increasing as our populations live longer thanks to advances in medical therapies. This is reflected by an increase in both usage and number of critical care beds as compared with total hospital beds across the United States. As this aging population suffers more and more from multiorgan dysfunction, including but not limited to respiratory failure, cardiac failure, and acute kidney injury, technologies are used to facilitate recovery in those that would have assuredly passed away years ago. Some of these advancements include extracorporeal membrane oxygenation and continuous kidney replacement therapy. In this article, we review the literature regarding the history, technology, indications, and outcomes of synchronous extracorporeal membrane oxygenation and kidney replacement therapy.
Assuntos
Injúria Renal Aguda , Oxigenação por Membrana Extracorpórea , Insuficiência Respiratória , Injúria Renal Aguda/terapia , Idoso , Humanos , Terapia de Substituição Renal , Insuficiência Respiratória/terapia , TecnologiaRESUMO
The substantial burden of acute kidney injury and end-stage kidney disease among patients with critical illness highlights the importance and need for a specialized nephrologist in the intensive care unit. The last decade has seen a growing interest in a career focused on critical care nephrology. However, the scope of practice and job satisfaction of those who completed dual training in nephrology and critical care are largely unknown. This article discusses the current practice landscape of critical care nephrology and describes the educational tracks available to pursue this pathway and considerations to enhance the future of this field.
