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移植后的早期术后乳酸增加与移植功能的延迟有关:一项回顾性队列研究
Benjamin Deniau1,2,3,4,5, Juliane Sen3, Maïté Chaussard3
1Université de Paris Cité, Paris, France.
Clinical transplantation
|March 23, 2024
概括
移植后的早期术后乳酸变化可以帮助预测延迟移植功能 (DGF). 手术后0至4小时的阳性乳酸变化趋势与较低的DGF风险有关,有助于早期预测.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 关键护理医学 关键护理医学
背景情况:
- 延迟移植功能 (DGF) 是移植后的常见并发症,影响了移植存活率和患者的结果.
- 早期识别患有DGF风险的患者对于及时干预和优化管理至关重要.
研究的目的:
- 为了研究早期手术后静脉乳酸变化和移植后DGF的发生之间的关联.
- 确定移植后期的乳酸动力学是否可以作为DGF的预测标志物.
主要方法:
- 一项回顾性队列研究,涉及从2021年2月到2022年12月的212名脏移植接受者.
- 静脉乳酸水平在手术后立即 (H0) 和4小时 (H4) 测量.
- 主要结局:DGF (定义为需要在移植后7天内进行置换疗法).
主要成果:
- 38名患者 (17.9%) 发生了DGF.
- 在患有DGF的患者中,在H0和H4之间更频繁地观察到阳性静脉乳酸变化 (增加乳酸产量), (85%对62%,p=0.011).
- 多变量分析显示,H0和H4之间的阳性静脉乳酸盐变化与降低DGF风险显著相关 (OR 0.30 [0.09-0.79],p=0.024).
结论:
- 早期的术后静脉乳酸变化,特别是在0到4小时之间的积极趋势,可以作为降低DGF风险的有价值预测指标.
- 这一发现可以帮助临床医生识别那些不太可能发展DGF的患者,并可能指导移植后护理策略.
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