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在重症监护中幸存者中,排放后估计的膜过率的纵向趋势
Rebecca M Glendell1, Kathryn A Puxty2,3, Martin Shaw3
1Undergraduate Medical School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
患有急性损伤 (AKI) 的重症监护病房 (ICU) 幸存者经历了更快的功能下降. 对这些患者来说,长期监测估计的膜过率 (eGFR) 非常重要.
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
- 流行病学 流行病学
背景情况:
- 急性损伤 (AKI) 是重症监护室 (ICU) 中经常出现的并发症.
- 关于ICU幸存者的长期结局的证据有限,特别是关于功能趋势的证据有限.
- 了解这些趋势对于改善患者管理和结果至关重要.
研究的目的:
- 在重症监护病房 (ICU) 幸存者中,以估计的球过率 (eGFR) 测量功能趋势的建模.
- 为了比较ICU幸存者与没有AKI之间的功能轨迹.
- 为了确定与ICU后加速eGFR下降相关的潜在风险因素.
主要方法:
- 一项观察性队列研究,涉及成年ICU幸存者 (16岁以上) 从苏格兰的两个一般成人ICU出院.
- 患者使用基线和随后的血清肌水平来诊断AKI并计算出院后的eGFR.
- 混合效应建模用于分析重复的eGFR测量和探索风险因素关联.
主要成果:
- 这项研究包括3649名患者,其中34%的患者在ICU中经历了AKI.
- 总体而言,ICU幸存者显示eGFR显著下降 (-1.9毫升/分钟/1.73m2/年).
- 与没有AKI (-1.83毫升/分钟/1.73m2/年) 的患者相比,AKI患者表现出加速的eGFR下降 (-2.0毫升/分钟/1.73m2/年).
- 预先存在的糖尿病,肝病和ICU中血管压缩剂的使用与更快的eGFR下降有关,无论AKI状态如何.
结论:
- 重症监护室的幸存者,特别是那些患有AKI的人,经历了功能显著下降,超出了预期的与年龄有关的变化.
- 这些发现强调了ICU幸存者的长期功能监测的重要性.
- 积极的管理和监测可能会降低与功能下降相关的长期发病率和死亡率.
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