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对比方法来使严重病患者的尿量正常化:一个多中心队列研究

Céline Monard^1,2, Nicolas Tebib¹, Bastien Trächsel³

¹Adult Intensive Care Unit, Centre Hospitalier Universitaire Vaudois, University Hospital of Lausanne, 1011, Lausanne, Switzerland.

Critical care (London, England)

|December 20, 2024

概括

在重症患者中,通过理想体重 (IBW) 将尿液输出 (UO) 规范化,可以稳定体重类别的寡尿症发病率. 这种方法改善了寡尿症与死亡率和急性病等结果之间的关联.

科学领域:

腎臟病學 (nephrology) 是一種醫學.
关键护理医学关键护理医学
临床流行病学临床流行病学

背景情况:

寡尿症的诊断依赖于按体重规范化尿液输出 (UO),但最优的规范化方法尚不清楚.
选择正常化方法可能会影响寡尿症发病率及其与患者结局的关联.

研究的目的:

调查不同尿液输出 (UO) 规范化方法对寡尿症发病率的影响.
为了确定哪个体重正常化变量最好预测重症监护室 (ICU) 患者的UO.
为了比较寡尿与死亡率和急性病 (AKD) 的关联,当UO被实际体重 (ABW) 规范化时,与最佳预测指标相比.

主要方法:

分析了来自瑞士和美国 (MIMIC-IV) 队列的成年ICU患者,但不包括接受维持血液透析或缺乏UO数据的患者.
理想体重 (IBW),体重指数 (BMI),身体表面积 (BSA) 和调整体重 (AdjBW) 被评估为潜在的UO正常化变量.
使用ABW与确定为正常化最佳UO预测因子的最佳UO预测因子进行了比较,比较了橄病发病率及其与90天死亡率和AKD的关联.

主要成果:

这项研究包括了超过43,000名患者的衍生和验证队列.
理想体重 (IBW) 被确定为尿液输出 (UO) 正常化的最佳预测指标.
与ABW相比,IBW的正常化导致重量类别的寡尿病发病率稳定,并改善了90天死亡率和AKD的预测.

结论:

通过理想体重 (IBW) 规范化尿液输出 (UO),在患者的体重类别中提供稳定的寡尿病发病率.
使用IBW用于UO正常化,增强了寡尿症和不良结果之间的关联,包括死亡率和AKD.
建议IBW用于重症患者的UO正常化,以提高诊断准确性和预测结果.

关键词:

定义定义定义寡头主义 (Oliguria) 是一种尿液输出量尿液输出量重量重量重量重量重量

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