极度酸性病重症患者的预后:一项回顾性研究
Lílian Rodrigues Henrique1, Micaela Bianchini Souza2, Riad Mahmoud El Kadri2
1Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil; Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Journal of critical care
|July 22, 2023
概括
在患有极度酸性病的重症患者中,酸性病的类型没有影响死亡率. 然而,乳酸水平升高表明预后较差,影响治疗强度和住院时间.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 肺部病理学 肺部病理学
背景情况:
- 极度酸化 (pH <7) 是重症监护室 (ICU) 患者的危急病症.
- 了解不同类型的酸性结核病对结果的影响对于患者管理至关重要.
研究的目的:
- 评估各种极端酸化亚型对重症患者住院死亡率的影响.
- 确定二次结局,包括血管压缩剂的使用,机械呼吸 (MV),置换疗法 (RRT) 和停留时间.
主要方法:
- 追溯的队列研究222重症患者的pH值<7.
- 使用简化斯图尔特方法分析临床数据和血液气体结果.
- 主要结局:住院死亡率;次要结局:血管压缩剂使用,MV,RRT,住院时间.
主要成果:
- 代谢性酸化症 (33.8%) 和混合性酸化症 (55%) 比呼吸道酸化症 (11.3%) 更常见.
- 总体死亡率为42.8%,在酸性化亚型之间没有显著差异 (p=0.26).
- 与乳酸<4 mmol/L (27.7%;p=0.007) 患者相比,在未测量的离子间隙酸性和乳酸≥4 mmol/L的患者中观察到较高的死亡率 (55.6%).
结论:
- 极端酸化的主要亚型不能独立预测危急病患者的死亡率.
- 酸性亚型影响了血管压缩器的使用,机械通风和医疗保健资源的利用.
- 超乳酸血症是极端酸性病的危重病患者预后不佳的重要预测因素.
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