ÁP DỤNG KỸ THUẬT LỌC MÁU LIÊN TỤC Ở BỆNH NHÂN ĐƯỢC TRAO ĐỔI OXY QUA MÀNG NGOÀI CƠ THỂ TẠI TRUNG TÂM HỒI SỨC TÍCH CỰC BỆNH VIỆN BẠCH MAI: HAI TRONG SỐ CÁC PHƯƠNG THỨC THƯỜNG ĐƯỢC SỬ DỤNG TRƯỚC MÀNG – SAU MÀNG VÀ TRƯỚC MÀNG – TRƯỚC BƠM

Abstract

Objective: To evaluate the techniques of different combination methods when applying continuous renal replacement therapy (CRRT) simultaneously in patients undergoing extracorporeal membrane oxygenation (ECMO). Participants: Patients receiving both CRRT and ECMO simultaneously at the Centre for Critical Care Medicine, Bach Mai Hospital. Methods: This is a descriptive, observational study conducted on patients receiving both CRRT and ECMO simultaneously. A total of 48 patients admitted to the center between August 2023 and June 2024 were included in the study, with 158 dialysis sessions performed until the patients were discharged. The two most commonly used combination methods were: the blood draw line of the CRRT machine connected to the post-pump, pre-membrane position of the extracorporeal circulation machine, and the return blood line of the CRRT machine connected either pre-pump or post-membrane of the extracorporeal circulation machine. These methods are referred to as post-membrane–pre-pump (64 sessions) and pre-membrane–pre-pump (56 sessions). The study compared pressure parameters, filtration rates, and filter lifespan between these two connection methods. The CRRT machines used in the system were Prismaflex and Prismax, and the ECMO machines were from Terumo or Maquet. Results: Statistically significant differences were observed in Access pressure, Return pressure, and filtration rates between the two combination methods, but no significant differences were found in filter lifespan. Conclusion: The study shows that both connection methods are safe for the CRRT system, do not affect ECMO flow, and do not impact filter lifespan.