Abstract 13712: Clinical Predictive Tool for Pediatric Cardiac Patients on Extracorporeal Membrane Oxygenation Therapy and Ultrafiltration

• Published in: Circulation (New York, N.Y.) N.Y.), 2021-11, Vol.144 (Suppl_1), p.A13712-A13712
• Main Authors: Sedler, Jennifer, Sutherland, Scott M, yarlagadda, vamsi V, Jahadi, Ozzie, Uber, Amanda M, Kwiatkowski, David
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.144.suppl_1.13712

IntroductionFluid overload is common among pediatric cardiac patients receiving ECMO. It is often treated with in-line ultrafiltration (UF) with some patients progressing to continuous renal replacement therapy (CRRT). We assessed whether requiring CRRT was associated with increased morbidity and mortality compared to UF alone. Additionally, we evaluated characteristics associated with the progression from UF to CRRT to create a clinical decision support tool to help identify patients likely to require CRRT. HypothesisPediatric cardiac patients on ECMO who require CRRT have increased morbidity and mortality compared to UF alone and can be identified at the time UF is initiated. MethodsRetrospective chart review of patients age ≤18 years treated with ECMO from 1/14-12/19 at a single quaternary care cardiac ICU. Bivariate comparisons using Chi-square or Fisher’s Exact and Mann-Whitney U tests were used as appropriate. ROC curve was used to create a tool predictive of the need for CRRT at the time of initiation of UF. ResultsOf 131 ECMO patients, 45 (32%) underwent UF and 13 (10%) UF then CRRT. Patients who required CRRT had a higher creatinine and BUN at time of UF initiation (p=0.04 and p= 50mL/kg in the 24 hours prior to UF initiation, and urine output