了解急性损伤管理中的流体动力学和 perfusion
Antonio Messina1,2, Marta Calatroni3,4, Gianluca Castellani5
1Department of Anesthesia and Intensive Care Medicine, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano - Milan, 20089, Italy. antonio.messina@humanitas.it.
Journal of clinical monitoring and computing
|August 28, 2024
概括
急性损伤 (AKI) 是一个重要的ICU挑战. 本综述指导了AKI患者的流体管理,生物标志物和治疗方法,强调谨慎的流体管理,以防止过载.
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
背景情况:
- 急性损伤 (AKI) 在重症监护室 (ICU) 普遍存在,特别是在老年患者和患有慢性疾病的患者中.
- AKI增加了发病率,死亡率和医疗保健费用,这给临床带来了重大挑战.
- 正常的功能依赖于通过管球球体反和神经激素机制对内血流的自我调节.
研究的目的:
- 审查ICU患者中AKI的特征.
- 为AKI提供关于流体管理策略的指导.
- 讨论生物标志物和药理干预在AKI管理中的作用.
主要方法:
- 文献综述检查了AKI的特征,风险因素和管理策略.
- 对AKI流体管理现有证据的分析.
- 对AKI的生物标志物和药理方法的评估.
主要成果:
- 常见的AKI危险因素包括体积枯竭,血液动力学不稳定,炎症,毒性和线粒体功能障碍.
- 流体管理至关重要,但由于AKI患者体积过载的风险,必须避免过度服用.
- 介绍了关于最佳流体管理,生物标志物利用和药理疗法的指导.
结论:
- AKI在ICU中构成重大威胁,需要谨慎管理.
- 优化液体管理,使用适当的生物标志物,并考虑药理学策略是改善AKI结果的关键.
- 本综述提供了在ICU环境中对AKI护理的综合方法.
相关概念视频
Dialysis
277
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...
277
Heart Failure Drugs: Diuretics
352
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...
352
Factors Affecting Renal Clearance: Renal Impairment
62
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...
62
Fluid Movement Between Compartments
494
The force applied by fluids against a surface, known as hydrostatic pressure, initiates the transfer of fluid among different compartments. Within our blood vessels, the blood's hydrostatic pressure is a result of the heart's pumping action. At the arteriolar end of capillaries, hydrostatic pressure (capillary blood pressure) exceeds the opposing colloid osmotic pressure created primarily by plasma proteins like albumin. This discrepancy in pressure propels plasma and nutrients from the...
494
Renal Failure: Dose Adjustments
69
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...
69
Renal Drug Clearance: Overview
146
Renal clearance is a crucial parameter in pharmacokinetics that quantifies the rate at which the kidneys excrete a drug. It represents a constant fraction of the central volume of distribution containing the drug that the kidney eliminates per unit of time.
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...
146


