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用连续脏替代疗法治疗的AKI的流行病学和结果:多中心CRRTnet研究
Oleksa G Rewa1, Victor Ortiz-Soriano2, Joshua Lambert3
1Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton Alberta Canada.
Kidney medicine
|June 5, 2023
概括
针对急性损伤 (AKI) 的连续置换疗法 (CKRT) 显示了多样化的实践. 败血症是AKI的主要原因,液体过载是常见的CKRT指示,突出了对护理基准的需求.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 持续置换疗法 (CKRT) 对患有急性损伤 (AKI) 的危急病患者至关重要.
- 现有的CKRT实践表现出显著的变化,需要更新的流行病学数据以改善护理.
研究的目的:
- 了解CKRT在重症成年患者的当代流行病学.
- 在不同中心识别患者特征,AKI贡献者和CKRT指示.
主要方法:
- 一个多中心,有望生活的登记.
- 从2013年12月到2021年1月,1,106名患有AKI需要CKRT的重症成人被录取.
- 收集和描述性地分析了患者特征,AKI原因,CKRT指示和结果的数据.
主要成果:
- 败血症 (42.6%) 是导致AKI的主要疾病,而寡尿症/无尿症 (56.2%) 和液体过载 (53.9%) 是最常见的CKRT指示.
- 整体医院生存率为41.1%. 死亡的患者年龄较大,并患有更多的并发症和更高的疾病敏度.
- 在各中心观察到患者特征和CKRT实践的显著异质性,尽管标准化死亡率相似.
结论:
- 败血症是AKI的主要原因,流体管理是CKRT的首要指示.
- 在CKRT实践中观察到的异质性强调了建立交付,性能和患者结果的基准的必要性.
- 来自该注册表的数据可以为未来研究的设计提供信息,以标准化CKRT护理.
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