Table 2.

Treatments for AKI in ECMO

Treatment	Pros	Cons
IHD	Potentially joinable with the main ECMO circuit	Rapid fluid removal and hemodynamic instability
	Reduced downtime	Disequilibrium syndrome and potential risk of cerebral edema
	Lower costs than CRRT	Technically more complex and demanding
Prolonged IHD	Potentially joinable with the main ECMO circuit	Potentially associated with hypotension in high-risk patients
	Slower volume and solute removal than IHD	Technically more complex and demanding
	Reduced downtime and costs compared with CRRT
CRRT	Potentially joinable with the main ECMO circuit	Patient immobilization Increased risk of hypothermia High costs
	Continuous removal of toxins Hemodynamic stability Tight and easy control of fluid balance Gentle solute removal avoiding disequilibrium syndrome Potentially allows blood purification therapies for systemic inflammation
	Potentially allows blood purification therapies for systemic inflammation
PD	Hemodynamic stability	Mainly restricted to the pediatric population and to patients already treated with chronic PD
	Technically simple	Requires specific intraperitoneal catheters Risk of peritonitis
	Lower cost	Impairs diaphragmatic movements, potentially prolonging the weaning from ECMO

IHD = Intermittent hemodialysis; PD = peritoneal dialysis.