在接受预防性移植的患者中,在麻醉期间需要考虑的因素:倾向性得分匹配分析
Jeayoun Kim1, Kyo Won Lee2, Keoungah Kim3
1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Korea.
BMC anesthesiology
|August 5, 2023
概括
与非预防性移植 (KT) 患者相比,在麻醉期间,预防性移植 (KT) 患者经历了更多的手术内低血压和代谢性酸,而非预防性移植 (KT) 患者则经历了更多的手术内低血压和代谢性酸. 麻醉科医生必须对预防性KT接受者的这些事件保持警.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 麻醉学 麻醉学
- 移植手术 移植手术
背景情况:
- 国际指导方针倾向于预防性移植 (KT) 而不是透析.
- 预防性KT通过避免透析并发症,改善了移植和患者的存活率.
- 在预防性KT中,麻醉可能发生在没有优化体积状态或纠正代谢问题的情况下.
研究的目的:
- 为了调查预防性KT比非预防性KT更频繁的麻醉事件.
- 为了比较两个组之间的手术内低血压和代谢障碍.
主要方法:
- 一个单一中心的回顾性研究将153名预防性KT患者与388名非预防性KT患者匹配,使用倾向分数.
- 主要结局:手术内低血压 (值以下的区域<70 mmHg).
- 二次结局:代谢酸性,电解质不平衡,血管压缩剂使用,输血,移植功能和重新手术.
主要成果:
- 预防性KT组显示显著更大的手术内低血压 (AUT:29.7 ± 61.5与14.5 ± 37.7相比,P=0.007).
- 在先发性KT组中,代谢性酸症更严重.
- 移植功能差异在统计学上是显著的,但在临床上是微不足道的.
结论:
- 在活体捐赠移植 (LDKT) 期间的预防性KT中,手术内低血压和代谢性酸较为常见.
- 麻醉科医生需要更高的准备能力来管理这些麻醉事件在预防性KT患者.
相关概念视频
01:26Kidney Transplant II: Surgical Procedure
36
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
36
01:28Kidney Transplant I: Introduction
29
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
29
01:16Kidney Transplant III: Nursing Management
39
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
39
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
35
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
35
01:28Cardiac Catheterization I: Pre-Procedure Overview
62
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
62
01:17Factors Affecting Renal Clearance: Renal Impairment
119
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
119