Fluid Balance and Recovery of Native Lung Function in Adult Patients Supported by Venovenous Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy.
ASAIO J
; 65(6): 614-619, 2019 08.
Article
en En
| MEDLINE
| ID: mdl-30379653
ABSTRACT
Fluid overload is associated with increased mortality in adult patients with acute respiratory distress syndrome. In patients requiring venovenous extracorporeal membrane oxygenation (VV-ECMO), the effects of fluid removal on survival and lung recovery remain undefined. We assessed the impact of early fluid removal in adult patients supported by VV-ECMO and concomitant continuous renal replacement therapy, in an 18-bed tertiary intensive care unit between 2010 and 2015. Twenty-four patients met inclusion criteria, of these 15 (63%) survived to hospital discharge. In our patient group, a more negative cumulative daily fluid balance was strongly associated with improved pulmonary compliance (2.72 ml/cmH2O per 1 L negative fluid balance; 95% confidence interval [CI] 1.61-3.83; P < 0.001). In addition, a more negative mean daily fluid balance was associated with improved pulmonary compliance (4.37 ml/cmH2O per 1 L negative fluid balance; 95% CI 2.62-6.13; P < 0.001). Survivors were younger and had lower mean daily fluid balance (-0.33 L [95% CI -1.22 to -0.06] vs. -0.07 L [95% CI -0.76 to 0.06]; P = 0.438) and lower cumulative fluid balance up to day 14 (-4.60 L [95% CI -8.40 to -1.45] vs. -1.00 L [95% CI -4.60 to 0.90]; P = 0.325), although the fluid balance effect alone did not reach statistical significance.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Equilibrio Hidroelectrolítico
/
Oxigenación por Membrana Extracorpórea
/
Terapia de Reemplazo Renal Continuo
/
Pulmón
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
ASAIO J
Asunto de la revista:
TRANSPLANTE
Año:
2019
Tipo del documento:
Article
Pais de publicación:
EEUU
/
ESTADOS UNIDOS
/
ESTADOS UNIDOS DA AMERICA
/
EUA
/
UNITED STATES
/
UNITED STATES OF AMERICA
/
US
/
USA