Table 2 Advantages and disadvantages of each renal replacement modality during extracorpo-real membrane oxygenation (ECMO)
Modality | Advantages | Disadvantages |
|---|---|---|
IHD | Integration in ECMO circuit possible Reduced filter downtime Lower costs than CRRT | Need for more rapid fluid removal Risk of hemodynamic instability Disequilibrium syndrome |
PIRRT | Integration in ECMO circuit possible Reduced filter downtime Lower costs than CRRT Slower volume and solute removal than IHD | Risk of hemodynamic instability in high-risk patients |
CRRT | Integration in ECMO circuit possible Continuous fluid and solute removal Allows more precise control of fluid balance Better hemodynamic stability | Patient immobilization Increased risk of hypothermia High costs |
PD | Better hemodynamic stability Technically simple Lower cost No addition of anticoagulation | Less experience in adult patients Requires specific intraperitoneal catheters Risk of peritonitis Risk of hyperglycemia May interfere with diaphragmatic movements |