功能标记物预测了重症患者的输出失败:一项回顾性研究
Rodrigo Cerqueira Borges1, Andrey Wirgues Sousa, Flaubert Luíz Rocha
1Author Affiliations: Department of Physical Therapy, Samaritano Higienópolis Hospital, Sao Paulo, Brazil (Drs Borges, Sousa, and Rocha); Department of Physical Therapy, University Hospital of the University of São Paulo, Sao Paulo, Brazil (Dr Borges); Department of Cardiology, School of Medicine, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil(Dr Rocco); Department of Physical Therapy, Amil Group, Sao Paulo, Brazil (Dr Lima); and Department of Intensive Care Unit, Samaritano Higienópolis Hospital, Sao Paulo, Brazil (Dr de Almeida).
包括急性损伤 (AKI) 在内的功能标志物与机械通风后的输出失败有关. 功能受损增加了需要重新灌输的可能性,突出了它在断奶决策中的重要性.
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
- 肺部病理学 肺部病理学
背景情况:
- 预测机械通风的输出成功仍然具有挑战性.
- 现有的输出管和断奶预测器缺乏一致的准确性.
- 功能在输出管的结果中的作用需要进一步研究.
研究的目的:
- 评估功能标志物与输出管失败之间的关联.
- 要确定急性损伤 (AKI) 是否预测需要重新输管.
- 为了确定特定的脏参数,与出管的决定相关.
主要方法:
- 追溯研究分析了两年的电子医疗记录.
- 纳入标准:成人患者 (≥18岁) 接受侵袭性机械通风 (MV) ≥48小时.
- 输出失败定义为在气管切除后48小时内重新输入管;AKI通过KDIGO分类进行评估.
主要成果:
- 在167名受试者中,15%的受试者经历了输出失败.
- 输出失败组显示较低的肌素清除率 (42毫升/分钟 vs 100毫升/分钟) 和较高的液体平衡 (739毫升 vs -189毫升).
- 患有AKI的患者的输出失败可能性增加了2.7倍 (OR=2.7;95%CI:1.6-4.7;P<0.01).
结论:
- 功能障碍与更高的输出失败率显著相关.
- 液体平衡和血清肌水平是出口决定时需要考虑的潜在因素.
- 评估功能可能会改善成功输出管的预测,并降低重新输入管率.
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