接受连续置换治疗的≤10公斤儿童的特征和结果:WE-ROCK研究
Shina Menon1,2, Michelle C Starr3, Huaiyu Zang4
1Department of Pediatrics, Center for Academic Medicine, Pediatric Nephrology, Lucile Packard Children's Hospital, Stanford University, MC-5660, 453 Quarry Rd, Palo Alto, CA, 94304, USA. shinam@stanford.edu.
Pediatric nephrology (Berlin, Germany)
|August 20, 2024
概括
在儿童重症监护病房 (ICU) 中,体重≤10公斤且接受连续置换疗法 (CKRT) 的儿童的死亡率有所下降. 然而,90天不良事件的高率强调了对这些重症儿童进行持续监测的必要性.
科学领域:
- 儿科脏病学 儿科脏病学
- 关键护理医学 关键护理医学
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 持续置换疗法 (CKRT) 是急性损伤 (AKI) 和重症儿童体重≤10公斤的急性损伤 (AKI) 和流体过载 (FO) 的重要治疗方法.
- 之前的研究报告说,在这个脆弱的儿科患者群体中,重症监护室 (ICU) 的死亡率很高 (57%).
- 对接受CKRT的这些年轻患者的结果的当代数据有限.
研究的目的:
- 为了评估与ICU死亡率相关的特征,在接受CKRT的体重≤10公斤的儿童中.
- 在这个队列中,评估90天后 (MAKE-90) 重大脏不良事件的发生率.
- 将当代结果与未来儿科CRRT (ppCRRT) 注册表的历史数据进行比较.
主要方法:
- 在病 (WE-ROCK) 登记处 (2015-2021) 进行了多国,观察性全球脏置换结果合作探索 (WE-ROCK) 登记处的回顾性分析.
- 纳入标准:为AKI或FO接受CKRT的0-25岁儿童,重点是入院时体重≤10公斤的儿童.
- 评估结果:ICU死亡率和MAKE-90 (死亡,持续性功能障碍或90天内透析).
主要成果:
- 分析了210名儿科患者 (平均年龄为0.53岁) 的队列.
- 集中治疗室死亡率为46.5%,低于历史对照,但MAKE-90发生在72%的患者中.
- 在CKRT开始时,更高的儿科物流器官功能障碍得分 (PELOD-2) 与ICU死亡率和MAKE-90的几率增加有关.
结论:
- 与ppCRRT注册表相比,当代CKRT在≤10公斤儿童中的使用显示了较好的ICU存活率.
- MAKE-90的高发病率强调了长期显著的发病率,以及急需密切的出院后随访的必要性.
- 儿科物流器官功能障碍评分 (PELOD-2) 是这一群体不良结果的关键预测指标.
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