对于一名急性脏损伤的徒步旅行者而言,不适当的阿扎胺使用
Weston R Myers1, Charles Bawcom2, Cooper Schraudenbach2
1University of Arizona College of Medicine, Phoenix, AZ.
Wilderness & environmental medicine
|May 10, 2024
概括
对急性山病 (AMS) 的乙醇胺 (ACZ) 预防可能会导致急性损伤 (AKI) 的风险. 一名徒步旅行者从轮骨髓溶解和脱水中发展出AKI,ACZ作为一个促成因素,突出了指导方针之外的风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 高度医学 高度医学
- 运动医学 运动医学
背景情况:
- 乙胺 (ACZ) 经常用于高海拔旅行者的急性山病 (AMS) 预防.
- 使用ACZ有潜在的脏不良事件风险,包括急性损伤 (AKI).
研究的目的:
- 在使用预防性ACZ的徒步旅行者中呈现急性力性拉布多米解和随后的AKI病例.
- 突出ACZ在特定情况下对AKI发展的潜在贡献作用.
主要方法:
- 一个56岁的男性徒步旅行者的病例报告呈现了AKI的症状.
- 审查患者的药物,高度暴露,活动水平和临床表现.
- 分析AKI的促成因素,包括运动性狂肠分裂,脱水和ACZ使用.
主要成果:
- 徒步旅行者发生了急性劳动力拉布地质溶解和AKI,尽管暴露在中等高度和短时间 (<24小时).
- AKI归因于拉布地质溶解,脱水/低血压和ACZ的利尿作用的综合作用.
- 在AMS预防的推临床实践指南之外,ACZ被处方.
结论:
- 医疗提供者必须仔细权衡ACZ在AMS预防中的风险和益处.
- 应谨慎规定ACZ,避免在高度暴露和活动水平不符合指导方针建议的个体中使用.
- 这一案例强调了遵守临床指导方针的重要性,以防止与药物相关的不良事件,如AKI.
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