在烧伤患者中增加功能:与评估功能常用的方法发生和不一致
Scott W Mueller1, Brittany Blass2, Kyle C Molina3
1Department of Pharmacy, University of Colorado Hospital, Aurora, Colorado, USA.
概括
增加干净度 (ARC) 在烧伤患者中很常见,超过70%的人经历了它. 标准功能估计通常无法检测ARC,可能导致药物剂量不正确.
科学领域:
- 药理学 药理学是指药理学的学科.
- 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:
- 增强清除 (ARC) 表示超生理性功能,往往导致次治疗药物水平和治疗失败.
- 烧伤患者被认为是ARC的高风险患者,但其实际患病率和发病率仍未得到充分描述.
研究的目的:
- 为了确定烧伤患者中ARC的流行率和发病率.
- 为了在这个人群中比较测量的功能 (12小时尿液收集) 与常见的估计方法 (Cockcroft-Gault,MDRD,CKD-EPI-2021).
主要方法:
- 追溯分析了163个12小时尿液采集 (CrCl-12) 从68个烧伤患者超过13个月.
- ARC定义为CrCl-12>130毫升/分钟. 使用考克克罗夫特-高尔特,MDRD和CKD-EPI-2021公式估计的功能.
- 针对不同百分比的全身表面积 (TBSA) 的ARC流行率和发病率的比较.
主要成果:
- 在评估的烧伤患者队列中,ARC的流行率很高 (70.6%) 和发生率很高 (66.3%).
- 标准功能估计显示了与CrCl-12的中度到微弱的一致性,并且经常无法识别ARC.
- ARC与心力衰竭的发病率较低有关 (P = .007).
结论:
- 在烧伤患者中,ARC是常见的发现,无论TBSA的百分比如何.
- 通常使用的功能估计公式在烧伤患者中不可靠,可能导致药物剂量不足.
- 需要进一步的研究来确定高风险的ARC烧伤患者,并制定最佳的剂量策略.
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