成人心脏手术相关的急性损伤:联合共识报告
Jessica K Brown1, Andrew D Shaw2, Monty G Mythen3
1Department of Anesthesiology and Perioperative Medicine, the University of Texas, MD Anderson Cancer Center, Houston, TX.
Journal of cardiothoracic and vascular anesthesia
|June 24, 2023
概括
在心脏手术后预防急性损伤至关重要. 专家建议侧重于术前脏健康,术后护理包以及术后监测,以改善患者的治疗结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 急性损伤 (AKI) 是心脏手术后不良结果的重要贡献者.
- 与心脏手术相关的AKI (CSA-AKI) 在术后护理中构成了越来越大的挑战.
- 对于管理CSA-AKI.有必要制定基于证据的指导方针.
研究的目的:
- 提供专家的共识建议,为外科手术期间的团队管理CSA-AKI.
- 针对CSA-AKI的预防和早期检测策略.
主要方法:
- 通过联合多学科会议 (手术前期质量倡议和心脏病学会手术后增强康复) 制定的建议.
- 使用了修改后的Delphi过程和全面的证据审查.
- 建议使用推评估,开发和评价 (GRADE) 方法进行分级.
主要成果:
- 总共制定了13项基于共识的建议.
- 建议分为术前 (4),术后 (4) 和术后 (5) 阶段.
结论:
- 由于缺乏有效的CSA-AKI治疗方法,预防和早期检测至关重要.
- 策略包括优化手术前脏健康,心肺旁路捆绑,并保持evolemia.
- 利用先进的工具 (EMR,POCUS,生物标志物) 和目标导向治疗可以改善结果.
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