**Introduction/Hypothesis**
Patients treated with Extracorporeal Membrane Oxygenation (ECMO) are at high-risk of developing multiple organ dysfunction, acute kidney injury and fluid overload. Continuous renal replacement therapy (CRRT) has been increasingly utilized inpatients on ECMO to manage AKI and treat fluid overload. The aim of this study is to define the incidence of concomitant CRRT with ECMO therapy and to determine the predictive factors as well as overall impact of CRRT on patient outcomes such as mortality and renal recovery.

**Methods (e.g. case series, trial or case report)**
A retrospective observational study was carried out at Mayo clinic Rochester and Florida. Analysis includes all adult patients who were placed on VA ECMO between January 2019 to March 2022. The study population was classified into two groups: with CRRT and without CRRT. Demographic data, baseline clinical characteristics, treatments administered, laboratory parameters, mechanical ventilator and ECMO data and survival outcome were collected and analyzed.

**Results**
A total of 70 VA ECMO patients were included. Among these, 44(63%) patients required CRRT. The pre EMCO vital signs, laboratory, mechanical ventilator parameters and initial ECMO parameters were observed similar between the study groups. The median duration of ECMO (3 days vs. 6.5 days, p=0.003) was significantly higher in CRRT group; however, there was no difference in overall mortality, complications rate of ECMO, median duration of ICU stay (13 days vs. 24,p= 0.17), hospital stay (44 days vs. 38 days, p=0.3) and mechanical ventilation( 7 days vs 12.5, p= 0.3) between the two groups.

**Conclusion**
The study demonstrated that patients on VA ECMO who required CRRT had longer duration of ECMO run though the overall mortality, complication and duration of hospital stay was similar between the two groups. Further studies with greater sample size are required to understand the impact of CRRT on patient outcome in VA ECMO.



Continuous Renal Replacement Therapy (CRRT) in patients treated with veno-arterial extracorporeal membrane oxygenation