心肺旁路术期间的血高度是术后急性损伤的危险因素:双盲随机对照试验的结果
Staffan Svenmarker1, Helena Claesson Lingehall2, Gunnar Malmqvist1
1Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Perfusion
|March 21, 2024
概括
一种超大原溶液并没有增加心脏手术相关损伤 (CSA-AKI) 的风险. 然而,在接受手术的老年患者中,高血度独立增加了30%的CSA-AKI风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 麻醉学 麻醉学
背景情况:
- 心脏手术可能导致急性损伤 (AKI).
- 在心肺旁路术中使用的初始化溶液可能会影响AKI风险.
- 调查超小胞原始化溶液对心脏手术相关的AKI (CSA-AKI) 的影响至关重要.
研究的目的:
- 为了确定以添加曼尼托和缩物为基础的Ringer的酸原始溶液是否会增加CSA-AKI风险.
- 为了评估hyperosmolar原始化溶液和术后功能之间的关联.
主要方法:
- 一个双盲,前性随机受控试验,涉及195名年龄≥65岁的接受心脏手术的患者.
- 患者接受了标准的林格酸原体或超大原体 (林格酸,曼尼托尔,化).
- 使用病改善结果 (KDIGO) 定义评估了急性损伤.
主要成果:
- CSA-AKI (KDIGO第一阶段) 的总体发病率很低 (第1天为2.6%,第3天为5.6%).
- 在术后没有观察到血清肌氨酸水平的显著跨组差异.
- 高血性,患者年龄和手术持续时间被确定为CSA-AKI的独立风险因素.
结论:
- 在这项研究中,高聚原始溶液并没有增加CSA-AKI的发生率.
- 单单是血度升高与CSA-AKI风险增加30%有关.
- 需要进一步研究血高度作为CSA-AKI的危险因素.
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