Does the combination of CRRT and ECMO improve survival as a bridge to heart transplantation in advanced cardiac patients with acute renal failure?
Acute renal failure in advanced heart failure patients on ECMO is a grave prognostic sign, and combined CRRT and ECMO may serve as a necessary bridge to heart transplantation.
We conclude that mortality rate for acute renal failure in cardiac patients under ECMO continues to be high. Our data suggest that acute renal failure is generally a part of multiorgan failure. This unique form of acute renal failure, causes generalized edema and fluid overload despite still low serum creatinine and azotemia, and deteriorates rapidly to death. From this study shows, advanced cardiac failure may need more aggressive and early initiation of ECMO support before acute renal failure develops. Acute renal failure in advanced heart failure under ECMO support means a grave sign, need aggressive heart transplantation therapy as soon as possible. Combination of CRRT and ECMO might serve an alternative therapy bridging the temporary replacement treatment and heart transplantation in advanced cardiac patients.
Yap et al. (2003) studied this question.