在重症监护中进行中期和高风险手术后的术后寡尿症,一个队列分析
Rodolpho Augusto de Moura Pedro1, Guilherme Bittar Cunha2, Igor Pietrobom2
1General ICU, Hospital Vila Nova Star - Rede D'OR, São Luiz, Brazil; Oncological ICU, Hospital São Luiz Itaim - Rede D'OR, São Luiz, Brazil; Liver and Gastroenterology Intensive Care Unit, Hospital das Clínicas da Faculdade de Medicina de São Paulo, Brazil.
Journal of critical care
|November 22, 2024
概括
手术后的寡尿症很常见,并增加了急性损伤 (AKI) 的风险. 然而,大多数寡头患者没有发展AKI,质疑其作为AKI指标的使用.
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
- 外科手术的结果
背景情况:
- 寡尿症是一种常见的急性损伤 (AKI) 标志物,但可能是手术后的适应性反应,可能会高估AKI发生率.
- 术后一天寡尿的发生率和影响仍未得到充分研究.
- 这项研究解决了理解术后寡尿症作用的差距.
研究的目的:
- 为了确定术后寡尿症的发生率.
- 为了确定与术后寡尿症相关的危险因素.
- 分析小瘤患者的临床结果和AKI风险.
主要方法:
- 在两个巴西医院的四个重症监护室进行了回顾性队列研究.
- 包括在2018年1月至2022年12月期间接受中等和高风险手术的患者.
- 对1476名患者的分析,以评估寡尿症,AKI和相关因素.
主要成果:
- 34.4%的患者在手术后24小时内出现过寡尿症.
- 寡头患者的血管压缩剂使用率,非选择性手术,男性性别和基线肌水平较高.
- 虽然寡头患者的AKI发病率较高 (12.4%对3.6%),但87.6%的患者没有符合基于血清肌素的AKI标准.
结论:
- 在高风险手术患者中,术后寡尿症是常见的,并且与增加AKI风险有关.
- 寡尿症本身可能会高估AKI发病率,因为大多数寡尿症患者没有通过血清肌素表现出功能障碍.
- 需要进一步的研究来澄清尿液输出的作用,以诊断术后的AKI.
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