液体反应与肝移植手术后成功断奶有关
Ricardo Castro1,2, Pablo Born1, Felipe Muñoz1
1Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago Centro, Santiago 8330074, RM, Chile.
Journal of personalized medicine
|April 27, 2024
概括
在自发呼吸试验 (SBT) 之前使用被动腿抬起 (PLR) 进行个性化流体管理,改善了肝移植患者的输出成功. 尽管流体平衡高,但对液体有反应的患者取得了更好的结果.
科学领域:
- 关键护理医学 关键护理医学
- 移植手术 移植手术
- 血液动力学 血液动力学
背景情况:
- 在ICU患者中,积极的液体平衡可能导致液体过载,器官功能障碍和死亡率增加.
- 肝移植 (LT) 患者经常经历高的术后液体平衡.
- 评估液体反应对于优化患者管理至关重要.
研究的目的:
- 调查在自发呼吸试验 (SBT) 之前通过被动腿抬起 (PLR) 引导的个性化流体管理是否可以减少具有高流体平衡的LT患者的输出失败.
- 在这个特定的患者队列中评估液体反应和输出输出结果之间的关联.
主要方法:
- 一项前性研究涉及15名在ICU的LT患者.
- 在ICU入院 (T1) 和SBT前 (T2) 使用PLR评估的液体反应能力.
- 在SBT之前和之后监测的心脏指数 (CI) 变化 (T3).
主要成果:
- 15名患者中有12名是SBT前 (T2) 具有流体反应的患者.
- 液体反应患者在SBT期间显示CI增加 (p=0.045).
- 在T2中,所有对液体有反应的患者都成功地被抽管,而2/3的不反应的患者有断奶困难.
结论:
- 基于PLR和SBT的个性化流体管理可以促进LT患者更早的断奶和成功的输出.
- 心血管评估对于管理患有高液体平衡的危急手术患者至关重要.
- 这种方法可以减轻与肝移植后流体过载相关的风险.
相关概念视频
01:28Kidney Transplant I: Introduction
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
01:16Kidney Transplant III: Nursing Management
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...