术后高血清乳酸水平与脑瘤切除后的急性脏损伤有关
Seungeun Choi1, Jiwon You1, Yoon Jung Kim1
1Department of Anesthesiology and Pain Medicine.
Journal of neurosurgical anesthesiology
|January 31, 2024
概括
高的手术内血清乳酸水平与脑瘤手术后的急性损伤 (AKI) 有关. 乳酸监测可能有助于识别患有术后AKI风险的患者.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 神经外科 神经外科
- 麻醉学 麻醉学
背景情况:
- 手术后急性损伤 (AKI) 是神经外科手术后的一个重大并发症.
- 识别AKI的风险因素对于改善患者的治疗结果至关重要.
- 血清乳酸是组织氧化的标志物,可以指示患者的状态.
研究的目的:
- 调查手术期间血清乳酸水平与在接受脑瘤切除的患者中AKI发生率之间的关联.
- 确定手术期间乳酸盐的升高是否是术后AKI的预测因素.
主要方法:
- 对4131名接受脑瘤切除的患者进行了回顾性分析.
- 患者分为高 (>3.35 mmol/L) 和低乳酸的组.
- 倾向性得分匹配用于创建可比较组 (每组1005名患者).
- 基于病改善全球结果 (KDIGO) 标准的AKI诊断.
主要成果:
- 手术后的AKI发生在1.3%的患者中,高乳酸盐组的发病率更高 (3.3%对比0.6%).
- 高的手术内血清乳酸水平 (>3.35 mmol/L) 是AKI的独立预测因子 (OR 3.57).
- 其他预测因素包括低血pH值,低血红素和高血清葡萄糖水平.
结论:
- 术后血清乳酸水平升高与脑瘤切除后AKI风险增加显著相关.
- 在手术期间的乳糖监测可能有助于对AKI的风险分层.
相关概念视频
Kidney Transplant II: Surgical Procedure
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Acute Kidney Injury I: Introduction
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
Acute Kidney Injury IV: Diagnostic Studies and Prevention
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...


