危急病患者的酸状态:物理化学与化学. 传统的方法 传统的方法
Arianna Ciabattoni1, Davide Chiumello1,2, Simone Mancusi2
1Department of Anesthesia and Intensive Care, ASST Santi Paolo e Carlo, San Paolo University Hospital, 20142 Milan, Italy.
Journal of clinical medicine
|May 14, 2025
概括
危急病患者经常有酸干扰. 斯图尔特方法可能比标准基数过剩方法更准确,用于检测机械通风患者的这些变化.
科学领域:
- 关键护理医学 关键护理医学
- 生理学 生理学 生理学
- 生物化学 生物化学
背景情况:
- 危急病患者经常表现出酸变化.
- 了解这些失调对于有效管理至关重要.
- 机械通风患者代表了潜在的酸不平衡的重要亚组.
研究的目的:
- 确定机械通风ICU患者中酸变化的流行率和时间变化.
- 为了比较传统的标准基数过剩 (SBE) 方法与评估酸状态的斯图尔特方法.
- 随着时间的推移,评估这两种方法之间的一致性.
主要方法:
- 对机械通风ICU患者进行前性观察研究.
- 收取动脉血液气体,血液和尿液样本在ICU入院和第一天.
- 使用基于SBE和斯图尔特方法进行酸变量的比较.
- 评估两种方法之间的一致性.
主要成果:
- 在ICU入院时,32%的患者患有酸血症,17%患有血症;在第一天,这种情况转变为7%的酸血症和28%的血症.
- 在SBE和斯图尔特方法之间,代谢酸性和性疾病的患病率有所不同,特别是在第一天.
- 基于SBE和斯图尔特方法之间的一致性在两个时间点都很低.
结论:
- 大约50%的机械通风患者表现出酸变异,从入院时的酸血转变为 alkalemia 在第一天.
- 这些变化与二氧化碳和血白蛋白水平的变化有关.
- 斯图尔特方法在检测重症患者的酸干扰方面似乎更准确,特别是随着通风和流体状况的变化.
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