超血是连续毒性血液过和区域酸盐抗凝剂治疗的患者的死亡预测因素
Thais Oliveira Claizoni Dos Santos1,2, Carlos Eduardo Dos Santos Ferreira3, Cristóvão Luis Pitangueira Mangueira3
1Nephrology Division, Universidade Federal de São Paulo, Rua Botucatu, 740, São Paulo, SP, 04023-062, Brazil.
Scientific reports
|November 18, 2023
概括
在接受区域酸盐抗凝药连续毒性血液过的肝功能衰竭患者中,高酸盐水平表明死亡风险增加. 观察到酸盐的积累,但没有显著影响透析参数.
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
- 肝病学 肝病学是一种肝病学.
背景情况:
- 区域酸盐抗凝药 (RCA) 用于连续毒性血液过 (CVVHDF),特别是在肝衰竭 (LF) 患者中.
- 在接受RCA的LF患者中,酸盐的积累可能会发生,这可能会影响患者的治疗结果.
研究的目的:
- 为了评估重症监护室 (ICU) 中的血清酸盐水平,接受RCA的CVVHDF患者.
- 为了将酸盐水平与肝功能标志物以及LC患者的/酸盐比率 (Ca/Ci) 相关联.
- 在LF和非LF患者之间比较临床数据,存活率和透析参数.
主要方法:
- 一项前性队列研究,涉及200名接受CVVHDF-RCA的ICU患者.
- 每天进行血清酸盐测量.
- 与患有和没有LF的患者之间的生存,临床,实验室和透析数据的比较.
主要成果:
- 62名患者 (31%) 患有肝衰竭;他们表现出显著更高的血清酸盐水平.
- 透析剂量,过器寿命,全身电离和Ca/Ci比率在各组之间相似.
- 酸盐被确定为死亡的独立风险因素 (OR 11.3),在LF组的死亡率更高 (70.5%与51.8%相比).
结论:
- 超血是CVVHDF-RCA患者死亡的独立风险因素,特别是肝衰竭患者.
- 尽管LF患者的酸盐水平较高,但这种增加是有限的,并没有显著改变透析参数.
- 在酸盐水平,肝功能指标和Ca/Ci比率之间发现了微弱至中度的相关性.
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