儿科连续置换疗法中主要的脏不良事件
Dana Y Fuhrman1, Erin K Stenson2, Issa Alhamoud3
1University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
JAMA network open
|February 23, 2024
概括
持续置换疗法 (CKRT) 与年轻人的重大脏不良事件 (MAKE-90) 有关. 心脏并发症,更长的ICU停留时间和释放模式是MAKE-90在这个人群中的关键风险因素.
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
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 持续置换疗法 (CKRT) 对重症青少年至关重要.
- 在儿童群体中,CKRT后的长期结果仍未得到充分研究.
- 了解脏不良事件对于改善患者护理至关重要.
研究的目的:
- 确定儿科和年轻成人CKRT患者90天内发生重大脏不良事件的发生率 (MAKE-90).
- 确定与MAKE-90相关的风险因素,包括CKRT释放模式.
- 分析解放策略对患者结果的影响.
主要方法:
- 一项使用WE-ROCK注册表 (2015-2021) 的国际多中心队列研究.
- 包括0-25岁的患者,因急性损伤或液体过载而接受CKRT治疗.
- 评估了临床特征,CKRT参数和定义的MAKE-90结果.
主要成果:
- 在969名患者中,MAKE-90发生在65.0%的患者中.
- 心脏并发症,在CKRT之前更长的ICU入院时间,以及释放模式是显著的风险因素.
- 在28天内成功释放CKRT与MAKE-90.0的几率明显降低有关.
结论:
- 在接受CKRT治疗的年轻人中,主要的脏不良事件很常见.
- 风险因素包括心脏并发症,CKRT启动时间和释放策略.
- 对最佳CKRT释放实践的进一步研究是有必要的.
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