如何在急性损伤中形成积极的液体平衡:一项双国,观察性研究
Kyle C White1, Ary Serpa-Neto2, Rod Hurford3
1Intensive Care Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia; Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
在重症监护室 (ICU) 患有急性损伤 (AKI) 的患者中,由于液体摄入量超过尿液输出,形成了积极的液体平衡 (FB). 这种液体积累会增加死亡风险.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 流体管理流体管理
背景情况:
- 阳性流体平衡 (FB) 与急性损伤 (AKI) 诊断的重症监护室 (ICU) 患者的不良结果有关.
- 了解这种脆弱患者群体中积极FB的发展对于改善临床管理和患者结果至关重要.
研究的目的:
- 研究 AKI 危急病患者体液平衡的发展背后的机制和因素.
- 确定患者管理中的关键因素,这些因素导致AKI诊断后的液体积累.
主要方法:
- 进行了一项跨国,回顾性队列研究.
- 该研究包括被诊断患有AKI且不需要置换治疗的危急病患者.
主要成果:
- 急性损伤 (AKI) 发生在17.3%的患者中,通常在入院后两天.
- 在AKI诊断后,累积的FB逐渐增加,这是由于持续的晶体化物给药,营养摄入量和有限的尿量.
- 在AKI诊断后四天的FB阳性与医院死亡风险增加显著相关 (OR1.12).
结论:
- 患有AKI的ICU患者的积极液体平衡是诊断后常见的情况.
- 液体积累的结果是持续的晶体化物管理,营养液体摄入量,尿量不足和最低限度的利尿剂使用的结合.
- 目前的管理策略有助于流体过载,突出需要对AKI患者的流体管理方案进行修订.
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