稀释与缩区域酸盐抗凝剂在连续置换疗法中的比较:一项准实验性研究
Almudena Mateos-Dávila1,2, Antonio Jorge Betbesé Roig3, José Alberto Santos Rodríguez3
1Department of Fundamental and Medico-Surgical Nursing, Nursing School, Faculty of Medicine and Health Sciences, Campus Clínic, Universitat de Barcelona, Barcelona, Spain.
Nursing in critical care
|October 28, 2023
概括
统一连续脏替代疗法 (CRRT) 酸盐抗凝疗方案是可行的. 缩酸盐提供更长的过寿命,而稀释酸盐需要更多的电解质更换.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 密集护理医学 密集护理医学
- 生物化学 生物化学
背景情况:
- 持续置换疗法 (CRRT) 循环凝血仍然是一个重大挑战.
- 在重症监护室 (ICU) 缺乏标准化的协议来管理共存的酸盐度,可能会导致错误.
研究的目的:
- 评估在CRRT中统一两个不同的酸盐抗凝剂协议的安全性和有效性.
- 评估使用缩与稀释酸盐溶液对CRRT电路性能和患者管理的影响.
主要方法:
- 一项前性,准实验性研究,在第三级转诊医院ICU中进行了三年.
- 包括连续需要CRRT与酸盐抗凝药的成年患者,分为缩 (136 mmol/L) 和稀释 (18 mmol/L) 的酸盐组.
- 标准化酸盐剂量 (3.5 mmol/L) 和透析溶液,没有过后更换;酸盐是唯一的预过液.
主要成果:
- 缩酸盐组的过器寿命明显长 (p < 0.05).
- 稀释酸盐组需要更高的电解质替代发生率 (p < 0.001).
- 在缩酸盐组中观察到性化趋势,尽管在统计学上并不显著.
结论:
- 统一CRRT酸盐协议是可以实现的,为管理错误提供了潜在的解决方案.
- 缩酸盐表现出优越的过器寿命,而稀释酸盐则需要增加电解质管理.
- 这些发现支持在不同CRRT机器中推断统一的协议.
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