1: Acute Kidney Injury: Impact on ECMO Supported COVID-19 Patient Outcomes. Single Center Experience

Introduction: Acute kidney injury (AKI) appears frequently in patients supported with ECMO. AKI is common among patients with coronavirus disease and is associated with adverse outcomes. The aim of the study was to evaluate the impact AKI on outcomes of patients supported with ECMO due to COVID-19 in our institution. Methods: Ethical committee approved retrospective single center study. Analysis included all adult ECMO supported patients due to Covid-19 infection during recent pandemics. Patient’s demographic variables, procedural data and outcomes were collected from patient medical records. Patients with newly developed AKI while on ECMO support were compared with patients with good renal function. Results: In total 54 patients were supported with ECMO due to Covid-19 induced respiratory failure in our institution. In all cases VV ECMO configuration was used. Forty three patients (79%) developed AKI, 17(31%) needed renal replacement therapy (RRT). Patients with diagnosed AKI had higher FiO2 before ECMO initiation (92% vs 85%, p=0.09). The duration of ECMO support in patients who developed AKI and with preserved renal function did not differ (24±19 vs 17±11 days, p 0,23). Crude in-hospital survival was 32% in ECMO supported patients. Ten patients out of 43 (23.2%) with AKI and 7 patients out of 11 (64%, p=0.025) with preserved renal function survived to hospital discharge. Conclusions: Our study demonstrated that AKI developed during ECMO support in COVID-19 patients was associated with significantly lower survival rates.