碳氧血球蛋白作为心脏手术的潜在生物标志物 相关的急性损伤
Akinori Maeda1, Anis Chaba2, Ryota Inokuchi3
1Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia; Department of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan.
Journal of cardiothoracic and vascular anesthesia
|July 31, 2024
概括
心脏手术后碳氧血球蛋白 (CO-Hb) 水平升高表明急性损伤 (AKI) 的风险更高. CO-Hb是一种实用的生物标志物,用于识别患有心脏手术相关AKI (CSA-AKI) 风险的患者.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
背景情况:
- 碳氧血球蛋白 (CO-Hb) 是已知的血液溶解和炎症标志物.
- 血液溶解和炎症都是心脏手术相关急性损伤 (CSA-AKI) 的危险因素.
- 之前没有确定CO-Hb水平和CSA-AKI之间的直接关联.
研究的目的:
- 调查重症监护室 (ICU) 入院时的CO-Hb水平与CSA-AKI发生之间的关联.
- 确定CO-Hb是否可以作为CSA-AKI的预测生物标志物.
主要方法:
- 追溯队列研究包括1698名接受心脏手术的成年患者.
- 根据在ICU入院时测量的CO-Hb水平,患者被分为四分之一.
- 使用多变量逻辑回归分析来评估CO-Hb和CSA-AKI之间的独立关联.
主要成果:
- 在ICU入院时,CO-Hb的较高四分位数逐渐与CSA-AKI的风险增加有关.
- 最高的CO-Hb四分位数 (≥1.4%) 与CSA-AKI (OR 1.45,p=0.038) 独立相关.
- 患有CO-Hb≥1.4%的患者的术后肌素显著增加,RRT的发生率增加,以及到AKI或死亡的时间缩短.
结论:
- 在ICU入院时,CO-Hb水平≥1.4%是CSA-AKI的独立风险因素.
- CO-Hb 是从常规动脉血液气体测量中随时可用的生物标志物.
- 在CSA-AKI预防试验中,CO-Hb可用于实际风险分层和患者选择.
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