在COVID-19大流行期间快速实施紧急现场CKRT透析剂生产系统
J Pedro Teixeira1,2,3, Lisa Saa4, Kevin A Kaucher5
1Division of Nephrology, University of New Mexico (UNM) School of Medicine, MSC10-5550, 1 University of New Mexico, Albuquerque, NM, 87131, USA. jteixeira@salud.unm.edu.
BMC nephrology
|August 23, 2023
概括
在COVID-19大流行期间,一家医院成功实施了现场连续脏替代疗法 (CKRT) 透析剂生产系统,以克服供应链中断. 这一举措确保了在严重短缺期间不间断的患者护理.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 卫生系统管理管理卫生系统管理
背景情况:
- 在COVID-19大流行期间,供应链中断导致一个主要的学术医疗中心持续置换疗法 (CKRT) 透析剂的严重短缺.
- 现场透析剂生产的预先存在的备用计划迅速实施,以应对即将到来的制造解决方案耗尽问题.
研究的目的:
- 描述现场CKRT透析剂生产系统的紧急实施和结果.
- 在供应危机期间评估当地生产的透析液的安全性和有效性.
主要方法:
- 一个回顾性病例系列,涉及成年患者接受现场生产的CKRT透析剂治疗.
- 透析剂是使用间歇性血液透析机,缩剂,无菌的亲肠营养袋和3D打印连接器生产的.
- 结果包括透析剂成分,微生物污染,患者死亡率,SOFA分数和导管相关的血液感染 (CLABSI).
主要成果:
- 在13天的时间里,给22名患者注入了3,645升本地生产的透析液.
- 透析试验证实了适当的电解质组成和可接受的内毒素和细菌水平.
- 暴露后7天内没有报告任何CLABSI;然而,由于严重疾病而导致的住院死亡率很高 (81.8%).
结论:
- 本报告详细介绍了在流行病引起的短缺期间在美国学术医疗中心首次快速和成功地实施现场CKRT透析剂生产系统.
- 该经验为其他面临类似关键供应限制的机构提供了潜在的模型.
- 虽然有效地确保透析剂的可用性,但患者的高死亡率强调了这一队列中疾病的严重程度.
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