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在连续脏替代疗法中酸抗凝剂:多中心PICU研究波器相关结果的研究
Hasan S Kihtir1, Muhterem Duyu2, Mehmet E Mementoglu3
1Department of Pediatric Critical Care, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey.
概括
酸盐抗凝剂是儿科连续脏替代疗法 (CRRT) 的可行选择. 较高的初始酸盐输液剂量 (CID) 延长了过器的寿命,但可能会增加酸盐积累的风险.
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
- 药理学 药理学是指药理学的学科.
背景情况:
- 持续置换疗法 (CRRT) 对重症儿童至关重要.
- 为了保持电路通透性,CRRT需要抗凝剂.
- 酸盐抗凝剂为肝素提供了替代品,可能减少出血并发症.
研究的目的:
- 评估儿童CRRT中酸盐抗凝剂的疗效和安全性.
- 为了确定最佳的酸盐初始输液剂量 (CID) 以获得有效的抗凝剂和过器寿命.
- 评估酸盐积累和相关并发症的风险.
主要方法:
- 来自七个儿科重症监护室 (PICU) 的多中心数据集的后期分析.
- 包括需要CRRT的儿科患者 (28天至18岁).
- 分析的数据包括过器寿命,CID和酸盐积累标记.
主要成果:
- 平均有效过器寿命 (EFL) 为40.5小时 (限制为72小时) 和59小时 (总计).
- 初始CID≥2.7 mmol/L-bf与显著更长的总EFL (72小时与38.5小时相比) 相关.
- >72小时的CRRT增加了酸盐积累的几率 (OR,2.17). 较高的初始乳酸水平也预测了积累 (18%的危险增加). 酸锁综合征发生在6.3%的过器中.
结论:
- 酸盐抗凝剂是儿科CRRT的一个可行的选择.
- 初始CID≥2.7mmol/L-bf可以提高过器的寿命,但需要仔细监测酸盐的积累.
- 需要进一步的研究来优化CID并了解长期结果.
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