患有烧伤的患者急性损伤
Matthieu Legrand1, Audra T Clark2, Javier A Neyra3
1Department of Anaesthesia and Perioperative Care, Division of Critical Care Medicine, University of California San Francisco, San Francisco, CA, USA. Matthieu.Legrand@ucsf.edu.
Nature reviews. Nephrology
|September 27, 2023
概括
烧伤伤害经常导致急性损伤 (AKI),导致预后不佳. 早期的AKI预防侧重于液体平衡和避免毒素,而晚期的AKI则需要治疗败血症.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 烧伤护理 烧伤护理
- 关键护理医学 关键护理医学
背景情况:
- 烧伤带来了急性损伤 (AKI) 的重大风险,患病率在9-50%之间.
- 尽管烧伤患者的生存率有所提高,但AKI仍然是一个关键并发症,严重病例的死亡率超过80%.
- 烧伤患者的AKI是多因素的,涉及血液动力学不稳定性,全身炎症,亡,血液溶解,狂犬病溶解,吸烟,药物毒性和败血症.
研究的目的:
- 审查烧伤患者急性损伤 (AKI) 的流行病学,危险因素和管理策略.
- 为了区分早期和晚期AKI在烧伤伤害的原因和结果.
- 在烧伤护理的背景下,突出AKI的预防措施和支持性治疗方法.
主要方法:
- 对烧伤和急性损伤研究的文献综述.
- 对燃烧患者AKI导致的病因因素的分析.
- 综合目前关于预防和治疗AKI在这个人群中的证据.
主要成果:
- 在烧伤患者中,AKI的患病率很高 (9-50%),严重病例的死亡率>80%.
- 早期AKI的原因包括血液动力学问题和毒素;晚期AKI主要是由败血症驱动的.
- 晚期AKI与早期AKI相比,与更高的死亡率有关.
结论:
- AKI是严重的烧伤并发症,具有显著的死亡率.
- 预防早期的AKI需要血液动力学支持和避免毒药物.
- 管理晚期AKI需要及时识别和治疗败血症,以及支持性护理和明智使用毒素.
相关概念视频
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
21
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...
21
01:22Acute Kidney Injury I: Introduction
15
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
15
01:29Acute Kidney Injury III: Clinical Manifestations
15
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
15
01:29Acute Kidney Injury II: Pathophysiology
12
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
12
01:20Acute Kidney Injury V: Interprofessional Care
12
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
12
01:22Acute Kidney Injury VI: Nursing Management
19
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
19