在重症儿童的阿尔金宁血压输液期间血清度
Rafael Muff1,2, Verena Gotta3,4, Vera Jaeggi5
1Department of Intensive Care and Neonatology, University Children's Hospital Zurich, University of Zurich, 8008 Zurich, Switzerland.
Children (Basel, Switzerland)
|November 27, 2024
概括
在重症儿童中注入氨酸压缩常常会导致低血,尽管注入了. 密切监测和替代对于预防接受压素的儿科重症监护患者的不良影响至关重要.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 儿科重症监护中心儿童重症监护中心
- 儿科脏病学 儿科脏病学
背景情况:
- 静脉注射的阿尔金血压素 (AVP) 越来越多地用于重症儿童.
- 治疗AVP存在低血的风险,可能导致严重的长期后果.
- 在儿科重症监护病人的持续AVP输注中对低血的数据有限.
研究的目的:
- 研究在接受持续静脉注射AVP的重症儿童中低血的发生率和特征.
- 评估剂在缓解AVP诱导的低血的有效性.
主要方法:
- 在2016年至2022年期间,对儿科重症监护病房患者进行了静脉注射AVP治疗的回顾性分析.
- 纳入标准:接受持续静脉注射AVP的患者.
- 收集的数据:基线和最低血清度,到达值的时间,AVP剂量和的使用率.
主要成果:
- 包括170名儿科患者;死亡率为28.8%.
- 在AVP治疗期间,38.2%的患者出现了低血 (<135 mmol/L).
- 血清的中位数为137 mmol/L,发生在AVP开始后8.4小时,尽管中位数的摄入量为10.2 mmol/kg/d.
结论:
- 低血是AVP连续输注在重症儿童的常见并发症.
- 需要大量的给药来维持血清水平在生理范围之内.
- 强调需要对接受AVP的儿科患者进行警的电解质监测和及时的替代.
相关概念视频
Regulation of Sodium and Potassium
413
The regulation of sodium and potassium ion concentrations in the human body is a complex process governed primarily by hormones such as aldosterone, antidiuretic hormone (ADH), and atrial natriuretic peptide (ANP).
Sodium Regulation
Sodium ions make up approximately 90% of extracellular cations, with a normal blood plasma concentration of 136–148 mEq/L. A decrease in blood volume and pressure triggers the release of renin from granular cells in the juxtaglomerular complex (JGC), primarily...
Sodium Regulation
Sodium ions make up approximately 90% of extracellular cations, with a normal blood plasma concentration of 136–148 mEq/L. A decrease in blood volume and pressure triggers the release of renin from granular cells in the juxtaglomerular complex (JGC), primarily...
413
Hormonal Regulation
33.0K
The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.
33.0K
Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
479
Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
479
Antihypertensive Drugs: Vasodilators
479
Vasodilators, primarily affecting the smooth muscles within arterial and venous walls, are commonly used for hypertension treatment. Medications such as minoxidil and hydralazine primarily target arteries and arterioles, while sodium nitroprusside acts on arterioles and venules. Minoxidil, functioning as a prodrug, is metabolized by hepatic sulfotransferase into its active form, minoxidil sulfate, after oral administration. This metabolite binds to the sulfonylurea receptor (SUR) component of...
479
Formation of Concentrated Urine
1.5K
There is a gradient of solutes in the interstitial fluid from the renal cortex through the medulla, known as the medullary osmotic gradient. The juxtamedullary nephrons establish and maintain this gradient using countercurrent mechanisms with loops extending deep into the medulla. These nephrons also use countercurrent mechanisms to regulate urine volume and concentration. The interaction between the descending and ascending limbs of the nephron loop creates an osmotic gradient through...
1.5K
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
386
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
386


