在儿童中需要透析的急性损伤:一个多中心,新兴国家视角
Thais Lira Cleto-Yamane1,2, Conrado Lysandro R Gomes3,4, Paulo Cesar Koch-Nogueira5
1Clinical and Academic Unit of Nephrology, Pedro Ernesto University Hospital, Faculty of Medical Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil. thaiscleto@yahoo.com.br.
Pediatric nephrology (Berlin, Germany)
|March 6, 2024
概括
儿童急性损伤 (AKI) 需要置换疗法 (KRT) 的死亡率很高,特别是在年幼的儿童中. 早期死亡率和像ICU团队经验这样的因素对于改善中等收入国家的结果至关重要.
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:
- 急性损伤 (AKI) 构成重大威胁,特别是在新生儿和需要置换疗法 (KRT) 的儿童中.
- 儿科KRT患者的全球死亡率范围广泛,从10%到63%.
研究的目的:
- 分析中等收入国家接受KRT的AKI儿科患者的结局和死亡率.
- 确定影响这一脆弱群体生存的风险因素和保护因素.
主要方法:
- 一项多中心研究分析了巴西里约热内卢13年来接受KRT的693名患有AKI的儿科患者的数据.
- 从74家医院收集了数据,包括患者人口统计,并发病,诊断和治疗细节.
主要成果:
- 总体死亡率为65.2%,婴儿的死亡率更高 (55.6%为1岁以下).
- 高龄和原发性病与较低的死亡率有关,同时并发性疾病很常见 (66%).
- 重症监护室 (ICU) 团队的经验与死亡率的降低相关,特别是在大量的中心. 40%的死亡发生在KRT启动后48小时内.
结论:
- 需要KRT的儿科AKI与中等收入环境中的高死亡率有关.
- 早期死亡率和推迟转诊或治疗徒劳等因素需要进一步调查,以改善患者的治疗结果.
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