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在心脏手术后增强康复过程中术后体重增加
Alexandra Krüger1, Anna Flo Forner2, Jörg Ender2
1Heart Center Leipzig, University of Leipzig, Strümpellstraße 39, 04289 Leipzig, Germany.
Journal of cardiovascular development and disease
|June 27, 2023
概括
心脏手术后的液体过载是常见的,显著的体重增加表明了这一点. 这种情况与更长的住院时间和急性损伤的更高风险有关,在心脏手术 (ERACS) 后进行增强康复的患者中.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
背景情况:
- 在术后护理中,最佳的流体管理至关重要,特别是在心脏手术后增强恢复 (ERACS) 协议中.
- 流体过载是一种潜在的并发症,可能会对患者的结果产生负面影响.
研究的目的:
- 在已建立的ERACS计划中调查液体过载对患者结果和死亡率的影响.
- 为了确定是否增加的外科手术期间体重增加,作为液体过载的标记,与不良事件相关.
主要方法:
- 对2020年1月至2021年12月间连续接受心脏手术的患者进行了回顾性分析.
- 用ROC曲线分析,根据体重增加 (≥7公斤 vs <7公斤) 将患者分为两组.
- 倾向性得分匹配被用来比较群体之间的结果,包括住院时间 (LOS),pRBC输血率和术后急性损伤 (AKI) 发生率.
主要成果:
- 体重增加 (≥7公斤) 与更长的住院LOS (9天 vs. 8天) 有显著关联.
- 体重增加较高的患者表现出增加的PRBC输血率 (50%对36%).
- 在体重显著增加 (19.2%对9.8%) 的组中观察到术后AKI的发病率更高.
结论:
- 体重增加是心脏手术中流体过载的可靠指标.
- 心脏手术后的液体过载很普遍,并与长时间住院和AKI风险增加有关.
- 这些发现强调了ERACS协议中谨慎流体管理的重要性,以减轻不良结果.
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