在儿童的连续置换疗法中选择性cytopheretic设备的使用:一个队列研究与历史比较器
Stuart L Goldstein1, Nicholas J Ollberding2, David J Askenazi3
1Division of Nephrology & Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Kidney medicine
|April 5, 2024
概括
对患有急性损伤 (AKI) 的重症儿童,接受连续置换疗法 (CRRT),选择性细胞突变器械 (SCD) 治疗是安全的和可行的,显示了可能的生存益处.
科学领域:
- 儿科脏病学 儿科脏病学
- 临界护理医学 临界护理医学
- 生物医学工程 生物医学工程
背景情况:
- 患有急性损伤 (AKI) 的重症儿童需要持续置换疗法 (CRRT),面临高死亡风险.
- 选择性cytopheretic设备 (SCD) 提供免疫调节作用,先前的成年人研究表明改善了生存率和透析独立性.
研究的目的:
- 评估与SCD (CRRT-SCD) 集成的CRRT在重症儿童中的安全性和可行性.
- 将CRRT-SCD治疗的儿科患者的生存结果与历史CRRT队列进行比较.
主要方法:
- 展望性,多中心研究涉及22名重症儿童 (≥10公斤) 患有AKI和接受CRRT-SCD的多器官功能障碍.
- 使用多变量和贝叶斯分析,比较存活率和功能 (估计的膜过率,透析依赖) 与匹配的历史儿科CRRT队列.
主要成果:
- 报告了15个严重不良事件,没有一个与SCD相关.
- 在22名患者中,有17名患者存活到ICU出院或第60天.
- 两种分析方法都表明增加SCD可能有好处,大多数幸存者在60天后表现出正常的功能,没有透析依赖.
结论:
- 在患有AKI的重症儿科患者中,CRRT-SCD治疗是安全的和可行的.
- 在儿童中,将SCD添加到CRRT中表明了可能的生存益处.
- 需要使用更大的样本大小进行进一步的研究来证实这些发现.
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