患有急性损伤的儿童用刚性导管进行腹腔透析:单中心体验
Manasi Garg1, Lalitha A V2, Anil Vasudevan3
1Department of Pediatrics, Pondicherry Institute of Medical Sciences, Pondicherry, India.
Journal of pediatric intensive care
|December 4, 2024
概括
使用刚性导管进行腹腔透析 (PD) 是一种安全有效的急性损伤 (AKI) 治疗方法,用于资源有限的重症儿童,其功能和存活率得到改善.
科学领域:
- 儿科脏病学 儿科脏病学
- 关键护理医学 关键护理医学
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 急性损伤 (AKI) 在重症儿童中构成了重大挑战,特别是在资源贫困的环境中.
- 腹腔透析 (PD) 由于其简单性和可访问性,通常是首选的透析方式.
- 在这个易受伤害的人群中,评估急性PD用刚性导管的安全性和有效性至关重要.
研究的目的:
- 评估急性腹膜透析 (PD) 的实用性和安全性,使用严格的导管在重症儿童.
- 评估短期患者和脏结果,以及在儿科重症监护病房 (PICU) 中与PD相关的并发症.
主要方法:
- 一项回顾性研究分析了2014年至2019年期间用刚性导管进行急性PD的113名危急病患儿童的数据.
- 评估了结局,包括恢复和存活,并发症.
- 记录了PD开始时的患者状况,如机械呼吸和多器官功能障碍综合征.
主要成果:
- 败血症,登革热感染和溶血性尿素综合征是AKI最常见的原因.
- PD 证明了有效性,尿素和肌素水平显著改善.
- 三分之一的患者 (33.6%) 实现了完全的恢复;整体存活率为53.7%.
- 代谢并发症最常见 (39.8%),与导管相关的并发症为21.2%和周周炎为4.4%.
结论:
- 使用刚性导管的急性PD在缺乏软导管的环境中是一种可行的床边手术.
- 可以在可接受的并发症率下实现显著的溶解物清除.
- 在资源有限的环境中,PD为患有AKI的重症儿童提供了一种有价值的置换疗法选择.
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