手术后的液体积累与低估肺移植接受者的AKI严重程度有关
Stefan Kuhnert1,2, Janine Sommerlad1, Henning Gall1,2
1Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus-Liebig-University Giessen, Giessen, Germany.
Clinical transplantation
|September 16, 2024
概括
肺移植后的液体积累可以掩盖急性损伤 (AKI). 调整流体平衡可以改善AKI检测,并识别患有较高死亡风险的患者,有助于肺移植接受者的预后.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植 移植 移植 移植
- 临界护理医学 临界护理医学
背景情况:
- 肺移植后的液体积累 (LTx) 可以稀释血清肌素 (SCr),可能影响急性损伤 (AKI) 的评估.
- 这项研究研究了流体平衡 (FB) 对AKI诊断,分期和LTx患者的结果的影响.
研究的目的:
- 评估液体平衡调整血清肌素对肺移植受体急性损伤 (AKI) 的诊断和分期的影响.
- 确定AKI对该患者群体所有原因死亡率的影响,考虑液体平衡.
主要方法:
- 从2005年至2018年,对131名成年LTx患者进行了回顾性分析.
- 在移植后7天内评估AKI发生,将原始SCr与FB调整后的SCr进行比较.
- 定义了过渡性和持续性AKI,并分析了它们与死亡率的关联.
主要成果:
- 在使用原始SCr.的患者中,58.8%的患者被诊断出AKI.
- 经FB调整后的SCr在20.6%的病例中低估了AKI的严重程度,在6.9%的病例中显示了额外的AKI,在23.4%的病例中显示了上升阶段.
- 低估的AKI显示死亡率更高 (HR 2.98);持续的AKI是死亡率的独立风险因素 (HR 2.35).
结论:
- 调整流体平衡可以提高肺移植接受者的AKI检测灵敏度.
- 评估AKI后脏恢复模式有助于识别高风险患者.
- 这种方法可以改善肺移植接受者的预后和结果.
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