Evidence map›Paper›PMID 38386072›Full record

ReviewPediatric nephrology (Berlin, Germany)2025

Concurrent use of continuous kidney replacement therapy during extracorporeal membrane oxygenation: what pediatric nephrologists need to know-PCRRT-ICONIC practice points.

Rupesh Raina, Nikhil Nair, Jonathan Pelletier, Matthew Nied, Tarik Whitham, Kush Doshi, Tara Beck, Goeto Dantes, Sidharth Kumar Sethi, Yap Hui Kim and 6 more

Abstract readReview
PubMed Publisher
In one paragraph

Review in Pediatric nephrology (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 47% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 12 institutions in 5 countries.

Rupesh RainaDepartment of Nephrology, Akron Children's Hospital, Akron, OH, USA. rraina@akronchildrens.org.ORCID http://orcid.org/0000-0003-3892-8376
Nikhil NairCase Western University School of Medicine, Cleveland, OH, USA.
Jonathan PelletierDivision of Critical Care Medicine, Department of Pediatrics, Akron Children's Hospital, Akron, OH, USA.
Matthew NiedDepartment of Internal Medicine, Case Western Reserve / University Hospitals, Cleveland, OH, USA.
Tarik WhithamDepartment of Pediatrics, College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA.
Kush DoshiAkron Nephrology Associates/Cleveland Clinic Akron General Medical Center, Akron, OH, USA.
Tara BeckDepartment of Pediatrics, University of Pittsburgh Medical Center Children's Hospital, Pittsburgh, PA, USA.
Goeto DantesDepartment of Surgery, Emory University, Atlanta, GA, USA.
Sidharth Kumar SethiPediatric Nephrology, Kidney Institute, Medanta, The Medicity, Gurgaon, Haryana, India.
Yap Hui KimDepartment of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Timothy BunchmanDepartment of Pediatric Nephrology, Children's Hospital of Richmond, Richmond, VA, USA.
Kahild AlhasanPediatric Nephrology, King Saud University, Riyadh, Saudi Arabia.
Lisa LimaDepartment of Pediatric Critical Care, Emory University, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Isabella GuzzoDivision of Nephrology and Dialysis, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Dana FuhrmanDepartment of Pediatrics, University of Pittsburgh Medical Center Children's Hospital, Pittsburgh, PA, USA.
Matthew PadenDepartment of Pediatric Critical Care, Emory University, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Emory University · USAkron Children's Hospital · USChildren's Hospital of Pittsburgh · USBambino Gesù Children's Hospital · ITChildren's Hospital of Richmond at VCU · USCleveland Clinic · USKing Saud University · SAMedanta The Medicity · INNational University of Singapore · SGNortheast Ohio Medical University · USUniversity Hospitals of Cleveland · USUniversity School · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Extracorporeal membrane oxygenation (ECMO) provides temporary cardiorespiratory support for neonatal, pediatric, and adult patients when traditional management has failed. This lifesaving therapy has intrinsic risks, including the development of a robust inflammatory response, acute kidney injury (AKI), fluid overload (FO), and blood loss via consumption and coagulopathy. Continuous kidney replacement therapy (CKRT) has been proposed to reduce these side effects by mitigating the host inflammatory response and controlling FO, improving outcomes in patients requiring ECMO. The Pediatric Continuous Renal Replacement Therapy (PCRRT) Workgroup and the International Collaboration of Nephrologists and Intensivists for Critical Care Children (ICONIC) met to highlight current practice standards for ECMO use within the pediatric population. This review discusses ECMO modalities, the pathophysiology of inflammation during an ECMO run, its adverse effects, various anticoagulation strategies, and the technical aspects and outcomes of implementing CKRT during ECMO in neonatal and pediatric populations. Consensus practice points and guidelines are summarized. ECMO should be utilized in patients with severe acute respiratory failure despite the use of conventional treatment modalities. The Extracorporeal Life Support Organization (ELSO) offers guidelines for ECMO initiation and management while maintaining a clinical registry of over 195,000 patients to assess outcomes and complications. Monitoring and preventing fluid overload during ECMO and CKRT are imperative to reduce mortality risk. Clinical evidence, resources, and experience of the nephrologist and healthcare team should guide the selection of ECMO circuit.

Indexed as

Acute Kidney InjuryContinuous Renal Replacement TherapyExtracorporeal Membrane OxygenationChildHumansInfant, NewbornNephrologistsPractice Guidelines as TopicAcute kidney injuryAnticoagulationCKRTECMOPediatrics

Identifiers

PMID38386072
OpenAlexW4392053280

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.