在需要连续脏替代疗法的ECMO患者中,与住院后透析依赖相关的因素
Carlos Rodrigo Franco Palacios1, Rudiona Hoxhaj2, Catlyn Thigpen2
1Critical Care Medicine, WellStar Health System, Marietta, GA, USA.
Renal failure
|April 24, 2024
概括
大多数需要持续脏置换疗法 (CRRT) 的体外膜氧化 (ECMO) 的患者恢复功能. 超脂血症和更长的CRRT持续时间预测住院后持续透析依赖.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 心血管外科心血管外科
背景情况:
- 急性损伤 (AKI) 是患者需要体外膜氧化 (ECMO) 的常见并发症.
- 持续置换疗法 (CRRT) 经常用于管理ECMO患者的AKI.
- 在ECMO-CRRT后预测长期透析依赖对于患者管理至关重要.
研究的目的:
- 在接受ECMO并需要CRRT的患者中确定与门诊透析依赖相关的变量.
- 描述ECMO-CRRT幸存者的恢复模式.
主要方法:
- 单中心回顾性研究.
- 在2016年至2022年期间需要ECMO-CRRT的202名患者的分析.
- 多变量回归分析以确定住院后透析依赖的预测因素.
主要成果:
- 52.5%的患者在住院后幸存下来,76.5%的患者在出院前恢复了功能.
- 23.5%的幸存者在住院后需要透析.
- 超脂血症 (OR 6.08) 和较长的CRRT持续时间 (OR 1.09) 与住院后透析依赖性有关.
- 最终脱离透析的患者的基线GFR比从未恢复功能的人更高.
结论:
- 在ECMO患者中,需要CRRT的AKI与高死亡率有关.
- 大多数ECMO幸存者在出院前实现了透析独立.
- 超脂血症和长时间的CRRT持续时间是持续透析需要的关键预测因素.
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