新生儿心脏手术后的利尿反应:来自NEPHRON合作的报告
Joshua J Blinder1, Jeffrey Alten2, David Bailly3
1Division of Cardiology, Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, CA, 94304, USA. jblinder@stanford.edu.
Pediatric nephrology (Berlin, Germany)
|May 7, 2024
概括
新生儿心脏手术后的早期利尿反应 (DR) 预测不良,长时间的机械通风或呼吸支持. 然而,DR在手术后识别严重急性损伤 (AKI) 时表现出公平的歧视.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 新生儿手术 新生儿手术
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 在新生儿心脏手术后,关于早期利尿反应 (DR) 的数据有限.
- 了解早期DR是否预测不良结果至关重要.
研究的目的:
- 在新生儿心脏手术后分析早期的利尿反应 (DR).
- 为了确定早期的DR是否预测了不良的临床结果,如长时间的机械通风 (MV) 和呼吸辅助 (RS).
主要方法:
- 使用NEPHRON注册表进行回顾性队列研究.
- 随机森林机器学习用于ROC-AUC和赔率比率.
- 使用观察/预期比率的第90百分位,定义长期的MV/RS.
- 评估的二次结局包括CICU/医院LOS和功能衰竭 (III阶段AKI).
主要成果:
- 早期DR预测长期MV (AUC0.611) 和RS (AUC0.674) 的情况不佳.
- 尿液反应显示了对功能衰竭的公平歧视 (AUC 0.703).
- 在患有长期MV和RS的患者中观察到较低的累积尿液输出 (UOP).
结论:
- 在这个队列中,早期的利尿反应是长期MV,RS和LOS的糟糕预测因素.
- 早期的DR可以识别严重的术后急性损伤 (AKI) 现型.
- 需要进一步的研究来探索早期或晚期DR与其他AKI指标的实用性.
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