手术后急性损伤和肺移植后的长期结果
Ernest G Chan1, Gilbert Pan2, Sarah Clifford1
1Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.
The Annals of thoracic surgery
|July 6, 2023
概括
肺移植后的术后急性损伤 (AKI) 是常见的,并且与死亡率的增加有关. 风险因素包括较高的肌素和延迟的胸部闭塞,严重的AKI需要置换疗法 (RRT) 具有最糟糕的结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 肺部病理学 肺部病理学
- 移植手术 移植手术
背景情况:
- 急性损伤 (AKI) 是肺移植后的一种严重的术后并发症.
- 描述外科手术期间的风险因素和AKI的结果对于改善患者管理至关重要.
研究的目的:
- 为了确定肺移植后AKI的手术前和手术内风险因素.
- 报告与早期术后期AKI发展相关的结果,包括存活率.
主要方法:
- 对接受初级肺移植 (2011-2021) 的成年患者的回顾性分析.
- 根据KDIGO标准定义的AKI,按脏替代疗法 (RRT) 的需要分层.
- 用于确定风险因素和生存影响的多变量分析.
主要成果:
- 在754名患者中,近一半 (48.9%) 患有AKI;117人需要RRT.
- 手术前的肌素,较低的eGFR,延迟的胸部闭塞和血液产品体积是AKI的危险因素.
- 手术后的AKI,特别是AKI-RRT,与更高的死亡率,更长的通风和更长的住院时间有关.
- AKI独立地预测了更糟糕的移植后生存率.
结论:
- 手术前和手术后的因素对肺移植后的AKI发展有显著的贡献.
- 手术后的AKI是减少长期生存的强有力的预测指标.
- 严重的需要RRT的AKI与肺移植后最差的生存结果有关.
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