连续置换疗法和儿童和年轻人的生存:来自跨国WE-ROCK合作的发现
Michelle C Starr1, Katja M Gist2, Huaiyu Zang2
1Division of Nephrology, Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.
概括
大约三分之二的儿科和年轻成人患者在接受连续脏替代疗法 (CKRT) 时幸存下来,在重症监护室出院. 存活率与CKRT处方细节无关,但可能受到并发症的影响.
科学领域:
- 儿科脏病学 儿科脏病学
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 关于儿童和年轻成年人群中持续置换疗法 (CKRT) 的流行病学和结果的数据有限.
- 在这种人口群体中了解CKRT实践和生存对于改善患者护理至关重要.
研究的目的:
- 描述患者特征,CKRT处方和接受CKRT的儿童和年轻成年人的生存关联.
- 为了确定影响严重疾病的儿科患者需要脏支持的结果的因素.
主要方法:
- 追溯多中心队列研究涉及980名患者 (出生至25岁) 在32个中心从2015-2021年.
- 收集关于CKRT启动,持续时间,模式,抗凝血和导管特征的数据.
- 用于分析患者人口统计和结果的描述性统计数据,包括存活到重症监护室 (ICU) 出院的存活率.
主要成果:
- 患者的中位年龄为8.8岁,CKRT启动时间平均为ICU入院后2天,持续时间为6天.
- 与酸盐抗凝药的连续毒静脉血液过是主要的模式 (62%).
- 在ICU出院后的总生存率为64.1%;然而,生存率与CKRT剂量,过器类型或抗凝药没有显著的关联,尽管并发症似乎会使结果恶化.
结论:
- 大约三分之二的儿科和年轻成年患者在CKRT上存活到ICU出院.
- 观察到的CKRT实践的变化,包括使用酸盐抗凝药连续毒性血液过的增加,与生存无关.
- 需要进一步的研究来探索伴随性疾病对这一患者群体结局的影响.
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