小児重症治療室でのセプシス関連急性腎損傷: 頻度と結果
Anosha Muhammad Aslam1,2, Wasif Ilyas Vohra1,2, Ariba Siddiqui1,2
1Department of Paediatrics, The Aga Khan University Hospital, Karachi, Pakistan.
まとめ
小児集中治療室 (PICU) でのセプシス関連急性腎損傷 (S- AKI) は,入院期間延長と死亡率増加に関連しています. S-AKIの早期発見と管理は,重症児のアウトカムを改善するために不可欠です.
科学分野:
- 小児重症治療薬
- 腎臓科
- 感染症
背景:
- セプシスは生命を脅かす臓器機能障害で 感染に対する宿主体の反応が 制御不能であるからです
- 急性腎臓損傷 (AKI) は,重症の子供,特にセプシス患者における一般的な合併症です.
- セプシスに関連したAKI (S-AKI) は,小児重症治療室 (PICU) の診断と管理においてユニークな課題を提示しています.
研究 の 目的:
- S- AKIと診断された小児患者の発生率と短期的なアウトカムを決定する.
- PICU集団におけるS-AKIの発症に関連する要因を分析する.
- S-AKIがPICUでの滞在期間と死亡率に与える影響を評価する.
主な方法:
- 2021年1月から2022年6月までの間,小児集中治療室 (PICU) で横断的な研究が行われました.
- セプシスで入院した小児患者 (1ヶ月から18歳) は,p- RIFLE基準を用いてAKIを評価した.
- データ分析には,変数とS-AKI間の関連性を特定するために,Chi-squareテストとロジスティック回帰が含まれていました.
主要な成果:
- 入院基準を満たした323人のセプシス患者のうち,56人 (17. 3%) がAKIを発症した.
- S- AKI患者では,平均PICU滞在時間が長かった (7. 04日対5. 24日),死亡率が高かった (39. 22%対20. 59%).
- 低血圧,小血圧,血中尿素窒素 (BUN) の上昇,代謝性酸性症候群は,S- AKIと有意に関連していた.
結論:
- セプシスに関連したAKIはPICUにおける重大な合併症であり,短期的な不良結果と関連しています.
- S- AKIの子供は,PICUでの長期滞在と,死亡リスクの大幅な増加に直面します.
- この発見は,小児性感染症患者に対する注意深いモニタリングと迅速な介入の重要性を強調しています.
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