在危急病的呼吸患者中导致低酸血症发展的因素:一项回顾性队列研究
Liran Statlender1,2, Orit Raphaeli3,4, Tzippy Shochat5
1Department of General Intensive Care, Rabin Medical Centre, Beilinson Hospital, Petah Tikva, Israel. liranst1@clalit.org.il.
Scientific reports
|August 26, 2024
概括
临界病患者常见的担忧是低酸血症,发现与较低的死亡率有关. 年龄和BMI等因素影响了它的发展,而禁食的持续时间并没有显著影响它的发生.
科学领域:
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 重症监护室的重症监护室的重症监护室.
背景情况:
- 低酸血症 (血清酸盐<2.5 mg/dL) 是在重症患者的营养支持启动期间的一个重大临床问题.
- 了解导致低血症的因素及其对患者结果的影响对于优化护理至关重要.
研究的目的:
- 为了确定与危急病患者的低酸血症发展相关的因素.
- 调查这个患者群体中低酸血症和死亡率之间的关系.
主要方法:
- 在混合ICU中对462名通风患者进行了回顾性队列研究.
- 分析包括人口统计,APACHE2,SOFA24,能源输送,酸盐水平,ICU停留时间,通风持续时间和死亡率.
- 考克斯的比例危险模型用于对低酸血症的死亡率分析,作为一个随时间变化的共变量.
主要成果:
- 在59.52%的患者中,出现了低酸血症.
- 降低低酸盐血症风险的因素包括年龄,BMI,糖尿病,APACHE2,SOFA24和脏SOFA分数.
- 由于创伤而入院增加了风险;低血与死亡率降低有关 (HR 0.447).
- 禁食时间长达72小时并没有显著影响低酸血症的发生.
结论:
- 几个患者和与疾病相关的因素影响了ICU中低酸血症的发展.
- 低酸血症,与常见的担忧相反,在这个队列中显示出与死亡率的保护性关联.
- 目前在营养支持之前的禁食协议似乎没有显著影响低酸血症的发生率.
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