中枢静脉压力与急性损伤之间的关联在感染性休克患者中发生
Nasrin Nikravangolsefid1,2, Jacob Ninan2,3, Supawadee Suppadungsuk1,4
1Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Journal of clinical medicine
|May 14, 2025
概括
在性休克患者中,中静脉压升高与急性损伤 (AKI) 的风险更高有关. 在12小时和48小时内监测CVP可以识别需要干预预防AKI的患者.
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
- 心血管生理学心血管生理学
背景情况:
- 败血症相关的急性损伤 (AKI) 显著增加死亡率和住院时间.
- 中枢静脉压力 (CVP) 和在败血症休克中AKI发展之间的确切关系尚未完全理解.
- 这项研究调查了CVP水平与感染性瘤发生率在感染性休克患者之间的关联.
研究的目的:
- 探索中枢静脉压力 (CVP) 与急性损伤 (AKI) 在被诊断为败血性休克的成年患者中的发生率之间的相关性.
- 为了确定CVP水平升高是否是该患者群体中AKI的独立风险因素.
- 根据CVP监测,确定潜在的干预时间窗口.
主要方法:
- 对于在梅奥诊所罗切斯特 (2006-2018) 住院的成年败血症休克患者的回顾性分析.
- 中心静脉压 (CVP) 被测量在毒症诊断后的6,12,24和48小时.
- 根据CVP值 (<8 mmHg与≥8 mmHg) 将患者分类为组;评估了AKI的发展.
主要成果:
- 在入院时没有AKI的3128名患者中,1098名 (35.1%) 患有AKI.
- 患有AKI的患者的中位数CVP水平显著更高,并且在所有测量时间点中,CVP升高的频率更高.
- 在多变量调整后,12小时和48小时心血管血压升高 (≥8 mmHg) 仍然与AKI发病率显著相关 (OR为1.60).
结论:
- 中心静脉压 (CVP) ≥8mmHg是感染性休克患者AKI的重要预测因素.
- elevated CVP 和 AKI 风险之间的关联即使在12小时和48小时以平均动脉压 (MAP) 进行调整后仍然存在.
- 这些发现突出了治疗干预的潜在12小时和48小时窗口,旨在降低CVP以减轻AKI风险.
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