富罗塞米德的反应预测了心脏手术后急性损伤的进展
Ying Su1, Yi-Jie Zhang1, Guo-Wei Tu1
1Cardiac Intensive Care Center, Zhongshan Hospital, Fudan University, Shanghai, China.
The Annals of thoracic surgery
|July 24, 2023
概括
罗塞米德反应性 (FR) 参数有效预测心脏手术后患者急性损伤 (AKI) 的进展. 结合FR可以改善早期风险识别,从而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
- 关键护理医学 关键护理医学
背景情况:
- 急性损伤 (AKI) 对患者的不良结果构成重大风险,早期识别高风险个体是一个关键的挑战.
- 接受心脏手术的患者特别容易受到AKI进展的影响.
- 在轻度至中度病例中,AKI进展的预测标记对于及时干预至关重要.
研究的目的:
- 评估furosemide响应 (FR) 的预测值,以确定心脏手术后轻度至中度AKI患者的AKI进展.
- 评估FR参数在改善现有临床模型以预测AKI进展方面的有用性.
主要方法:
- 分析了两个独立的队列 (中山前,伯特以色列女执事医疗中心后).
- 罗西米德反应率 (FR) 指数和修改后的FR指数是根据相对于罗西米德剂量和体重的2小时尿液输出计算的.
- 主要结局是手术后7天内发生AKI进展.
主要成果:
- 在两个队列中,AKI进展在16.0%和11.3%的患者中被观察到.
- 所有计算的FR参数都显示了与两组AKI进展风险的反向关联 (调整后P < .01).
- 包括FR参数显著提高了基线临床模型的预测准确度,C指数,净重新分类和综合歧视的改善证明了这一点.
结论:
- 在心脏手术后患有轻度至中度AKI的患者中,罗塞米德反应性参数与AKI进展风险相反相关.
- 将FR参数集成到临床模型中可以大大提高AKI进展的预测能力.
- 这些发现凸显了FR作为心脏手术后AKI患者早期风险分层的一个有价值的工具.
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