Separation Versus Integrated Approach in Combining ECMO With CRRT

Separation Versus Integrated Approach in Combining ECMO With CRRT, a Randomized Controlled Trial

This study aimed to compare circuit lifespan of CRRT between Integration and Separation techniques during ECMO support.

ECMO patients >18 years old who met the KDIGO criteria for acute kidney injury and required continuous renal replacement therapy (CRRT). Inclusion criteria were as follows:

1. Refractory acidosis, defined as pH < 7.2 or serum bicarbonate (HCO₃-) < 15 mmol/L
2. Refractory volume overload
3. Refractory hyperkalemia, defined as serum potassium (K⁺) > 6.2 mEq/L or presence of electrocardiographic changes
4. Anuria or oliguria, defined as urine output < 0.5 mL/kg/hr for 6-12 hours
5. Elevated BUN >100 mg/dL or presence of uremic symptoms Increased intracranial pressure

Exclusion Criteria:

1. Pregnancy
2. Heparin contraindication
3. Chronic kidney disease with CRRT
4. AKI with Glomerulonephritis, Interstitial nephritis, Vassculitis or Urinary tract obstruction