ArticleJournal of artificial organs : the official journal of the Japanese Society for Artificial Organs2018
Implementing a practice change: early initiation of continuous renal replacement therapy during neonatal extracorporeal life support standardizes care and improves short-term outcomes.
Article in Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 26 citations in OpenAlex.
- Effects of early continuous renal replacement therapy in critically ill patients requiring ECMO treatment: results of a randomised controlled trial.Open heart · 2026Trial
- Extracorporeal membrane oxygenation, acute kidney injury, fluid balance, and continuous renal replacement therapy: Acute Disease Quality Initiative (ADQI) and Extracorporeal Life Support Organization (ELSO) joint consensus conference.Intensive care medicine · 2026Article
- Korean Society of Nephrology 2025 Evidence-Based Clinical Practice Guideline for Continuous Kidney Replacement Therapy.Electrolyte & blood pressure : E & BP · 2026Review
- Korean Society of Nephrology 2025 evidence-based clinical practice guideline for continuous kidney replacement therapy.Kidney research and clinical practice · 2026Article
- Kidney replacement therapy during extracorporeal membrane oxygenation: pathophysiology, technical considerations, and outcomes.Renal failure · 2025Review
- Concurrent use of continuous kidney replacement therapy during extracorporeal membrane oxygenation: what pediatric nephrologists need to know-PCRRT-ICONIC practice points.Pediatric nephrology (Berlin, Germany) · 2025Review
- Efficacy and safety of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in the management of pediatric acute respiratory distress syndrome.Frontiers in pediatrics · 2025Article
- Fluid assessment, fluid balance, and fluid overload in sick children: a report from the Pediatric Acute Disease Quality Initiative (ADQI) conference.Pediatric nephrology (Berlin, Germany) · 2024Article
- Research progress on nutritional support in the neonatal and pediatric populations receiving extracorporeal membrane oxygenation.Frontiers in nutrition · 2024Review
- Continuous renal replacement therapy in patients treated with extracorporeal membrane oxygenation.Seminars in dialysis · 2021Review
- Letter to the Editor of the Journal of Artificial Organs: The flaws in the detail of describing methods, comparing patient cohorts and interpreting results.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2021Article
- Acute Kidney Injury and Extracorporeal Membrane Oxygenation: Review on Multiple Organ Support Options.International journal of nephrology and renovascular disease · 2021Review
- Fluid overload and fluid removal in pediatric patients on extracorporeal membrane oxygenation requiring continuous renal replacement therapy: a multicenter retrospective cohort study.Pediatric nephrology (Berlin, Germany) · 2020Observational
- Early continuous renal replacement therapy during infant extracorporeal life support is associated with decreased lung opacification.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2019Article
- Adjunctive Therapies During Extracorporeal Membrane Oxygenation to Enhance Multiple Organ Support in Critically Ill Children.Frontiers in pediatrics · 2018Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe hypothesized that a standardized approach to early continuous renal replacement therapy (CRRT) during neonatal extracorporeal life support (ECLS) results in greater homogeneity of CRRT initiation times with improvements in fluid balance and outcomes.
methodsRetrospective analysis of data (2007-2015) obtained from neonates treated prior to (E1; n = 32) and after (E2; n = 31) a 2011 practice change: CRRT initiation within 48 h of ECLS.
resultsBirthweight, gestational age, ECLS mode, and age at ECLS initiation were similar to each epoch. Survival [E1: median 75%, E2: 71%] and length of ECLS [E1: median 221 h, E2: 180 h] were comparable. During E2, 100% of infants received CRRT (vs. E1: 37%; p < 0.001) and 97% of infants initiated CRRT within 48 h of ECLS (vs. E1: 13%; p < 0.001). Control charts demonstrate reduced practice variation. Elapsed time from ECLS to CRRT differed between Epochs [E1: median 105 h, E2: 9 h; p < 0.001] as did weight at CRRT initiation [E1: 4.13 kg (29% above baseline), E2: 3.19 kg (0%); p < 0.001]. Significant differences in weight change were noted on days 6 and 7 (E1: 14%, E2: 2%; raw data comparison yielded p < 0.05) and curves were different (p < 0.05).
conclusionsWe successfully implemented a practice change, initiating CRRT within 48 h of ECLS cannulation, leading to decreased practice variation and improved short-term outcomes including decreased weight gain at CRRT initiation and faster return to baseline weight during the first 7 days of ECLS. We did not demonstrate changes in duration of ECLS, invasive ventilation, or survival.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.