Combination of extracorporeal membrane oxygenation and continuous renal replacement therapy: a systematic review of the past decade (2014–2023)
Bibliographic record
Abstract
OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) are often used together to treat critically ill patients. This systematic review aims to assess mortality and renal recovery with this combination as reported by studies published over the past decade. METHODS: We searched PubMed, Web of Science, ProQuest Health & Medical Complete, Embase, and Ovid SP. Two reviewers independently screened studies and extracted data. Study quality was assessed using the Newcastle-Ottawa Scale (NOS) for non-randomized controlled trials. We performed statistical analyses with RevMan 5.4. RESULTS: = 51%). However, when excluding one study which appeared to be driving this heterogeneity in a sensitivity analysis, mortality was significantly higher among patients treated with ECMO and CRRT (OR 1.43, 95% CI 1.15-1.77, p = 0.001). Subgroup analysis of only adult retrospective studies also yielded a higher mortality rate with ECMO and CRRT (OR 1.42, 95% CI 1.13-1.78; p = 0.003). No difference in mortality was seen when pooling the two paediatric retrospective studies (OR 0.90, 95% CI 0.68-1.19; p = 0.45) or the two prospective studies (OR 0.94, 95% CI 0.31-2.83, p = 0.91). Limited data on recovery of renal function prevented further analysis. CONCLUSION: In conclusion, in contrast to older data, our pooled analysis of recent studies revealed no significant increase in mortality risk associated with CRRT use in patient treated with ECMO. However, after accounting for heterogeneity, mortality remained higher in patients treated with ECMO and CRRT group than in the ECMO-alone group. Additional prospective data are essential to clarify the impact of CRRT on outcomes in patients treated with ECMO.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".