近年来，体外膜肺氧合（ECMO）作为急性呼吸循环功能障碍的危重症患者高级生命支持的重要手段，其临床应用与日俱增。这些患者往往合并急性肾损伤（AKI）和容量过负荷等，需要肾脏替代治疗（RRT）。启动连续性肾脏替代治疗（CRRT）的指征和最佳时机需根据患者容量状态和AKI相关代谢紊乱的严重程度进行个体化评估。在ECMO患者中CRRT可以通过多种方式与ECMO进行连接，尚没有证据表明ECMO和CRRT联合使用的不同方法会影响患者临床预后。ECMO和CRRT联合是一种安全有效的技术，可改善患者液体平衡，稳定内环境。本文重点解读《成人体外膜肺氧合技术操作规范（2024年版）》ECMO联合CRRT的指征、时机、联合方式、预后及危险因素等相关临床问题。

In recent years，extracorporeal membrane oxygenation （ECMO） has been increasingly used in clinical practice as a critical advanced life support modality for critically ill patients with acute respiratory/circulatory failure. These patients often develop complications such as acute kidney injury（AKI） and volume overload，necessitating renal replacement therapy （RRT）. The indications and optimal timing for initiating continuous renal replacement therapy （CRRT） should be determined through individualized assessment based on the patient's volume status and severity of AKI-related metabolic disturbances. In ECMO patients，CRRT can be connected to ECMO in various ways，and there is currently no evidence to suggest different methods of combining ECMO and CRRT affect clinical outcomes. The combined use of ECMO and CRRT is a safe and effective technique to improve fluid balance and stabilize the internal environment. We focus on interpreting key clinical issues that addressed in thePractice Standards for Adult Extracorporeal Membrane Oxygenation Technology （2024 Edition），including indications，timing，connection methods，prognosis and risk factors associated with ECMO-CRRT combined therapy.