内毒素与严重病患者的功能和逗留时间相关
Sian E Piret1, Sobia Khan1, Fabliha Fairuz1
1Division of Nephrology and Hypertension, Department of Medicine, Stony Brook University, Stony Brook, New York, USA.
Blood purification
|November 2, 2023
概括
危急病患者的高内毒素水平与功能恶化和更长的住院时间相关. 减少内毒素活性可能会改善急性损伤患者的治疗结果并加快恢复速度.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
背景情况:
- 内毒素是败血症和急性损伤 (AKI) 的主要驱动因素.
- 内毒素可以从关键病患者的肠道转移,即使没有细菌.
- 之前的研究在COVID-19患者中将内毒素与AKI联系起来.
研究的目的:
- 在重症患者中调查内毒性和脏/医院结局之间的相关性.
- 评估内毒素水平对急性损伤进展和恢复的影响.
主要方法:
- 在ICU入院48小时内对124名严重病情的成年患者进行前性研究.
- 循环内毒素水平使用内毒素活性测定 (EAA) 在第1,4和第8天测量.
- 分析EAA协会与结果的分析,分类并作为连续变量.
主要成果:
- 较高的EAA水平 (≥0.6) 与增加的蛋白尿和较低的氧化 (SaO2 / FiO2比率) 有关.
- 在第1天观察到EAA水平和血清肌素 (sCr) 之间的正相关性.
- 持久高EAA水平的患者的sCr下降速度较慢,住院时间较长.
结论:
- 增加的内毒素活性 (EAA ≥0.6) 与严重病患者的较差功能和不良结果有关.
- 在EAA水平下降或EAA初始低水平 (1日EAA<0.6) 和AKIII阶段的患者中观察到更快的恢复.
- 这些发现表明,减少循环内毒素可能是改善AKI结果的治疗目标.
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