分析代谢变化作为30天重症监护病人的预测30天重症监护病人的死亡率对接受连续脏替代疗法的患者进行分析
Vaidas Vicka1, Alvita Vickiene2, Sigute Miskinyte1
1Clinic of Anaesthesiology and Intensive Care, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
在接受连续脏替代疗法的急性损患者中发生的代谢变化会影响治疗结果. 较低的能量消耗和较高的葡萄糖水平独立地预测了30天重症监护室死亡率.
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.
- 代谢研究研究 代谢研究
背景情况:
- 患有急性损伤的患者在持续的置换疗法中经历了代谢变化.
- 这些代谢变化与较差的临床结果和增加的死亡率有关.
- 确定预测性死亡率标志物对于管理这些高风险患者至关重要.
研究的目的:
- 确定能独立预测30天重症监护室 (ICU) 死亡率的新陈代谢指标.
- 调查接受脏替代疗法的重症监护患者的新陈代谢状态和死亡率之间的关联.
主要方法:
- 一项前性观察性研究,涉及接受脏替代疗法的重症监护患者.
- 综合代谢评估包括能源消耗的间接热量计和无脂肪质量指数 (FFMI) 的生物电阻.
- 氨基酸和葡萄糖度的分析,并进行回归分析以确定死亡率预测因素.
主要成果:
- 在60名高风险患者中,50% (APACHE II评分22.98±7.87) 在30天内死亡.
- 与幸存者相比,没有幸存者的能量消耗和氨基酸度显著降低,葡萄糖度更高.
- 较低的能量消耗 (exp(B) =0.852) 和较高的葡萄糖 (exp(B) =1.360) 是30天ICU死亡率的独立预测因素.
结论:
- 代谢变化与持续置换疗法中急性损伤患者的ICU结局密切相关.
- 较低的全身氨基酸度,较低的能量消耗和较高的全身葡萄糖度预测30天ICU死亡率.
- 这些代谢标志物可以帮助风险分层和急性损伤重症患者的管理.
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