呼吸系统衰竭发展的预测因素在一个多中心的肝硬化住院患者队列
Jasmohan S Bajaj1, Patrick S Kamath2, K Rajender Reddy3
1Virginia Commonwealth University and Central Virginia Veterans Healthcare System, Richmond, Virginia, USA.
The American journal of gastroenterology
|November 8, 2023
概括
住院的肝硬化患者发展呼吸衰竭 (RF) 面临着糟糕的结果. 关键的风险因素包括急性损伤 (AKI),胃肠道出血和医院感染,突出了预防护理的必要性.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
背景情况:
- 肝硬化住院患者有呼吸衰竭 (RF) 的风险,这是一种与预后不佳相关的并发症.
- 这种人群中RF的诱导因素仍然不清楚,需要进一步调查.
研究的目的:
- 在肝硬化住院患者中确定导致呼吸衰竭 (RF) 的诱导因素.
- 分析住院和住院事件之间的关联以及RF的发展.
主要方法:
- 一个多中心的北美肝硬化住院患者队列的潜在招生.
- 收集住院和住院数据,包括欧洲肝脏研究协会-慢性肝脏衰竭评分,急性损伤 (AKI),感染和白蛋白使用.
- 多变量回归分析以预测RF使用RF前事件.
主要成果:
- 15%的被录取患者出现了RF. 与射频相关的因素包括较高的MELD-Na,胃肠道出血或AKI的入院,以及病房感染 (NI) 的发展.
- 专使用,特别是较高剂量,与高射频风险增加有关 (83%对59%).
- 多变量分析确定NI (OR=4.02),胃肠道出血 (OR=3.1),白蛋白使用 (OR=2.93),AKI (OR=3.26) 和循环衰竭 (OR=3.73) 作为RF的显著预测因素.
结论:
- 呼吸衰竭 (RF) 是住院肝硬化患者的重大并发症,发生在15%的病例中.
- 射频的风险因素包括AKI或胃肠道出血的入院,以及病房感染的发展,器官衰竭或专素的使用.
- 专注于体积状况,感染控制和脏和循环功能管理的预防策略对于降低射频风险至关重要.
相关概念视频
Acute Respiratory Failure-III
190
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
190
Acute Respiratory Failure-IV
160
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
160
Acute Respiratory Failure-V
143
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
143
Acute Respiratory Failure-II
249
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
249
Acute Respiratory Failure-I
218
Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
218
Respiratory Assessment: Purpose and Indications
1.1K
Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
1.1K


