在急性损伤中何时开始替代疗法:我们还在等什么?
1Department of Critical Care Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Journal of intensive medicine
|July 22, 2024
概括
急性损伤 (AKI) 管理包括平衡警等待与及时置换疗法 (RRT). 动态评估和生物标志物可以帮助确定重症患者的最佳RRT时间,避免延迟或不必要的干预造成伤害.
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
- 脏生理学 脏生理学
背景情况:
- 急性损伤 (AKI) 是一种具有高死亡率的严重疾病.
- 置换疗法 (RRT) 是AKI的主要治疗方法.
- 目前的指导方针建议在没有紧急RRT指示的重症患者中采取警等待策略.
研究的目的:
- 探索在重症AKI患者中启动RRT的最佳时间.
- 评估动态功能评估方法,以指导RRT决策.
- 确定预测RRT的好处的生物标志物.
主要方法:
- 在AKI中对RRT时间进行随机对照试验的审查.
- 动态功能评估技术的分析.
- 评估生物标志物,如与中性粒细胞凝酶相关的利波卡林和furosemide压力测试.
主要成果:
- 警等待在严重病情的AKI患者没有紧急RRT需要的情况下是安全的.
- 延迟RRT启动没有好处,可能会造成伤害.
- 动态功能评估和生物标志物有助于确定最佳RRT候选人和时间.
结论:
- 将RRT干预风险与AKI并发症风险之间的平衡至关重要.
- 动态评估需求-能力匹配是有价值的.
- 生物标志物和功能测试可以在AKI中指导个性化的RRT决策.
相关概念视频
Dialysis
286
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
286
Renal Failure: Dose Adjustments
78
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
78
Factors Affecting Renal Clearance: Renal Impairment
71
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
71


