阴离子间隙预测90天死亡率,并指导在ARDS中使用furosemide
Yu Li1, Wenjian Luo2, Qiuyue Wang1
1Department of Anesthesiology, Xinqiao Hospital, Army Medical University, Chongqing, 400038, China.
在急性呼吸窘迫综合征 (ARDS) 患者中,血清阳离子间隙 (AG) 升高表明死亡风险更高. 罗塞米德治疗可以减轻这种风险,特别是在AG水平最高的患者中.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 临床化学 临床化学
背景情况:
- 血清离子间隙 (AG) 可能表明缺氧期间有机功能障碍.
- 急性呼吸困扰综合征 (ARDS) 与显著的死亡率有关.
- 对ARDS的预后标记和治疗目标至关重要.
研究的目的:
- 研究血清AG作为ARDS患者短期死亡率的预后标志物.
- 探索血清AG作为ARDS的潜在治疗点.
- 评估血清AG水平与ARDS中的死亡率之间的关联.
主要方法:
- 使用MIMIC-IV数据库 (版本2.2) 进行回顾性队列研究.
- 包括11,227名患有ARDS的患者.
- 使用多变量考克斯比例危险分析,受限立方线和卡普兰-梅尔曲线.
主要成果:
- 血清AG水平升高与ARDS患者90天死亡率增加显著相关 (aHR1.23).
- 较高的AG水平显示出所有原因死亡的风险增加.
- 罗西米德在ARDS患者中表现出具有最高AG水平 (aHR0.57) 的保护作用.
结论:
- 血清AG是ARDS死亡率的显著预后标志物.
- 在ARDS患者中血清AG水平升高与死亡风险增加有关.
- 富罗塞米德可能是高血清AG水平的ARDS患者的有益治疗干预措施.
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