{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:14:11Z","timestamp":1777853651666,"version":"3.51.4"},"reference-count":50,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute kidney injury (AKI) is frequent in patients supported with venoarterial extracorporeal membrane oxygenation (VA-ECMO), largely due to the severity of cardiogenic shock and multiorgan failure. Renal replacement therapy (RRT) can be delivered either via an indwelling catheter (parallel system, PS) or through direct connection to the ECMO circuit (integrated system, IS). Their respective safety profiles, particularly regarding infectious, hemorrhagic, and circuit-related complications, remain insufficiently characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-center retrospective analysis of prospectively collected data from consecutive adults who received RRT for \u226524\u2005h while on VA-ECMO between 2006 and 2019. Complications occurring during the concomitant ECMO\u2013RRT period were compared between IS and PS configurations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighty patients (84 procedures: 42 IS, 42 PS) were included. Infectious complications occurred in 31% of IS procedures and 45.2% of PS procedures, with earlier onset in the PS group (3 vs 5 days; p = 0.048). However, in multivariable analysis, IS was not independently associated with reduced infection risk (OR 0.67 [0.27-1.70]; p = 0.421). Hemorrhagic events (54.8% IS vs 59.5% PS) and circuit dysfunctions, including filter clotting, were comparable between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In VA-ECMO patients requiring RRT, integrated and parallel configurations demonstrate similar safety profiles with no significant differences in infectious, hemorrhagic, or circuit-related complications. These findings support selecting the RRT configuration based primarily on local expertise and technical feasibility rather than expected differences in complication risk<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666261443238","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T14:42:06Z","timestamp":1776868926000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated or Parallel Configurations for Renal Replacement Therapy in Patients on VenoArterial Extracorporeal Membrane Oxygenation, a Single Center Retrospective Study"],"prefix":"10.1177","author":[{"given":"Floriane","family":"L\u2019Her","sequence":"first","affiliation":[{"name":"University Hospital of Rennes"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adel","family":"Maamar","sequence":"additional","affiliation":[{"name":"University Hospital of Rennes"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benoit","family":"Painvin","sequence":"additional","affiliation":[{"name":"University Hospital of Rennes"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoann","family":"Launey","sequence":"additional","affiliation":[{"name":"University Hospital of Rennes"},{"name":"Inserm U124, Universit\u00e9 de Rennes, CHU Rennes, Rennes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Mansour","sequence":"additional","affiliation":[{"name":"University Hospital of Rennes"},{"name":"Inserm CIC 1414 (Centre d'Investigation Clinique de Rennes), Universit\u00e9 de Rennes, CHU Rennes, Rennes, France"},{"name":"IRSET, UMR_S 1085, F35000, Inserm, Universit\u00e9 de Rennes, CHU Rennes, Rennes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Nesseler","sequence":"additional","affiliation":[{"name":"University Hospital of Rennes"},{"name":"Inserm CIC 1414 (Centre d'Investigation Clinique de Rennes), Universit\u00e9 de Rennes, CHU Rennes, Rennes, France"},{"name":"Institut NUMECAN - UMR_A 1341, UMR_S 1241, Inra, Inserm, Universit\u00e9 de Rennes, University Hospital of Rennes, Rennes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erwan","family":"Flecher","sequence":"additional","affiliation":[{"name":"University Hospital of Rennes"},{"name":"UMR 1099, Laboratoire Traitement du Signal et de l'Image (LTSI), Inserm, Universit\u00e9 de Rennes, Rennes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Marc","family":"Tadi\u00e9","sequence":"additional","affiliation":[{"name":"University Hospital of Rennes"},{"name":"UMR 1236 MOBIDIC, INSERM, \u00c9tablissement Fran\u00e7ais du Sang, LabexIGO, Universit\u00e9 de Rennes, Rennes, France"},{"name":"SITI Laboratory, University Hospital of Rennes, Rennes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3404-981X","authenticated-orcid":false,"given":"Mathieu","family":"Lesouhaitier","sequence":"additional","affiliation":[{"name":"University Hospital of Rennes"},{"name":"UMR 1236 MOBIDIC, INSERM, \u00c9tablissement Fran\u00e7ais du Sang, LabexIGO, Universit\u00e9 de Rennes, Rennes, France"},{"name":"SITI Laboratory, University Hospital of Rennes, Rennes, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu029"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-017-1633-1"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2307227"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181e8acf7"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60958-7"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.15277"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.12731211"},{"issue":"14","key":"e_1_3_4_9_2","first-page":"321","article-title":"Acute kidney injury and extracorporeal membrane oxygenation: Review on multiple organ support options","volume":"13","author":"Foti L","unstructured":"Foti L, Villa G, Romagnoli S, Ricci Z. 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