持续的弗鲁塞米德输液与间歇性玻尿酸治疗在儿科重症监护:一个单一中心的回顾性研究
Nutnicha Preeprem1,2, Emily See3,4,5, Siva P Namachivayam5,6,7,8
1Pediatric Intensive Care Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
概括
持续输液 (CI) 弗鲁塞米德在重症儿童中,在患有先天性心脏病 (CHD) 和更严重的急性损伤 (AKI) 的儿童中更为常见. CI的开始时间较晚,剂量也高于间歇性玻尿酸 (IB) 治疗.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 药理学 药理学是指药理学的学科.
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 弗鲁塞米德是重症儿童的重要利尿剂,通过连续输液 (CI) 或间歇性玻尿液 (IB) 给予.
- 了解弗鲁塞米德的使用模式和相关因素对于优化儿科重症监护至关重要.
- 急性损伤 (AKI) 是这一患者群体的一个重大问题.
研究的目的:
- 在儿科重症监护室 (PICU) 接受静脉注射弗鲁塞米德的儿童的特征.
- 描述CI与IBfrusemide管理的模式. 描述CI与IBfrusemide管理的模式.
- 为了调查与启动CIfrusemide相关的因素,包括AKI发病率.
主要方法:
- 对2017年至2022年期间入住PICU的儿童进行了回顾性观察研究.
- 对静脉注射弗鲁塞米德的分析 (CI与IB),重点关注患者的特征,时间,剂量和AKI.
- 使用多变量逻辑回归来确定与CI启动相关的因素.
主要成果:
- 在9394名PICU患者中,1387人接受了静脉注射弗鲁塞米德;16%的人接受了CI.
- 与IB相比,接受CI的儿童更年轻,PIM-3得分更高,先天性心脏病 (CHD) 更多,以及在开始时更高的AKI发病率/严重性.
- 与IB相比,CI的发病时间较晚 (46 vs. 19小时),剂量较高 (4.3 vs. 1.5 mg/kg/day);心脏病与CI的发病时间相关 (aOR 1.67).
结论:
- 与IB相比,静脉注射弗鲁塞米德CI在患有心脏病的PICU儿童中更为普遍,发病时间较晚,剂量较高.
- 接受CI弗鲁塞米德治疗的患者在治疗开始时表现出更高的AKI发病率和严重程度.
- 先天性心脏病是与在重症儿童中使用连续输液弗鲁塞米德相关的重要因素.
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