在患有急性损伤的重症患者中,从置换疗法中断
Kada Klouche1,2, Vincent Brunot1, Romaric Larcher1,2
1Intensive Care Unit Département, Lapeyronie University Hospital Montpellier, 34295 Montpellier, France.
Journal of clinical medicine
|January 26, 2024
概括
大多数急性损伤 (AKI) 的幸存者需要置换疗法 (KRT) 可以断奶. 早期断奶的支持是尿液 >500毫升/天,但预测参数需要验证.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 急性损伤 (AKI) 影响10%的危急病患者,通常需要置换疗法 (KRT).
- 需要KRT的AKI的死亡率接近50%,尽管大多数幸存者最终恢复了功能.
- 目前的指导方针缺乏最佳的KRT断奶时间的具体标准.
研究的目的:
- 系统地审查KRT (包括血液透析,CRRT和SLED) 并确定预测成功断奶的因素.
- 分析与KRT断奶相关的患者结果.
- 介绍早期KRT断奶的理由,指导参数和实际方式.
主要方法:
- 进行了对同行评审文献的系统审查.
- 审查的重点是KRT类型,断奶的预测因素和患者的结果.
- 包括的研究是观察性,分析临床和生物参数.
主要成果:
- 在KRT停止之前的尿液输出是成功断奶的最受研究和使用的预测因素.
- 分析的其他潜在预测因子包括尿尿尿素/肌素和新生物标志物,如囊素C和NGAL.
- 稳定体积状态优化的稳定患者的尿液超过500毫升/天,建议考虑断奶.
结论:
- 从KRT早期断奶得到了临床证据和特定参数的支持.
- 虽然尿液输出是一个关键指标,但需要进一步验证尿路参数来预测断奶成功.
- 在考虑停止KRT之前,优化患者的病情和尿液是关键的步骤.
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