在重症患者的连续替代疗法中,低血压的发生率和相关因素
Anliu Nie1, Shuzeng Zhang2, Mingju Cai1
1The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
International journal of nursing practice
|July 30, 2024
概括
在接受连续置换疗法 (CRRT) 的患者中,低血压很常见,影响超过27%的电路. 关键因素包括血管压缩剂的使用,CRRT前低血压和液体除去率.
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
- 临床研究 临床研究
背景情况:
- 持续置换疗法 (CRRT) 期间低血压的发生率和危险因素需要进一步调查.
- 了解这些因素对于优化重症监护室 (ICU) 患者护理至关重要.
研究的目的:
- 分析需要CRRT的患者中低血压发生率的回顾性数据.
- 确定与CRRT期间低血压发生相关的因素.
主要方法:
- 在2017年1月至2021年6月期间,在ICU接受CRRT的患者的回顾性分析.
- 使用多变量逻辑回归来确定与低血压相关的因素.
主要成果:
- 在140名患者中,低血压发生在27.3%的CRRT电路 (242/885) 中.
- 重要因素包括血管压缩剂的使用 (OR=5.731),CRRT前低血压 (OR=2.779),年龄 (OR=1.016),以及液体除去率 (OR=1.002).
- 较低的血清白蛋白 (OR=0.969),血清 (OR=0.514) 和CO2CP (OR=0.933) 也与低血压有关.
结论:
- 低血压是CRRT的常见并发症,特别是在早期阶段.
- 影响低血压的因素与心脏输出和外周电阻的变化有关,包括过度超,血管压缩剂的使用和血清电解质水平.
相关概念视频
Renal Failure: Dose Adjustments
77
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...
77
Factors Affecting Renal Clearance: Renal Impairment
69
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...
69
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
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
413
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
413
Antihypertensive Drugs: Direct Renin Inhibitors
521
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
521
Heart Failure Drugs: Diuretics
355
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
355


