在重症儿科患者中使用刚性导管进行急性腹膜透析的结果
Raajashri Rajasegar1, Madhileti Sravani2, Bobbity Deepthi2
1Pediatric Intensive Care Unit (PICU), Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education, and Research (JIPMER), Puducherry, India.
概括
使用刚性导管的急性腹膜透析 (PD) 在儿童中是安全的,腹膜炎的发病率随着PD持续时间的延长而增加. 这种方法在缺乏软导管的资源有限的环境中是可行的.
科学领域:
- 儿科脏病学 儿科脏病学
- 关键护理医学 关键护理医学
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 腹腔透析 (PD) 是儿童急性损伤 (AKI) 的可行的替代疗法.
- 有关硬导管并发症的担忧,例如腹膜炎,存在.
- 本研究探讨了在重症儿童中使用刚性导管的急性PD的安全性和结果.
研究的目的:
- 为了评估急性PD的结果,在重症儿童中使用刚性导管.
- 在这个人群中评估腹膜炎的发病率和与急性PD相关的机械并发症.
- 为了确定在资源有限的环境中用刚性导管进行急性PD的可行性.
主要方法:
- 对患有急性PD的儿科患者 (18岁以下) 的回顾性分析.
- 收集了关于初级诊断,PD指示,实验室参数和PD会话细节的数据.
- 评估结果,包括10年内炎和机械并发症的发病率.
主要成果:
- 202名儿童接受了PD,常见的症状包括流体过载,无尿症和高胆血症.
- 总共有14名 (6.9%) 儿童患有腹膜炎,其发病率随着导管再插入和延长PD持续时间 (>72小时) 显著增加.
- 机械并发症包括周周管泄漏 (13.8%),导管阻塞 (6.4%) 和出血污水 (3%).
结论:
- 使用刚性导管的急性PD,仅限于72小时的疗程,对于重症儿童来说是安全的和可行的,特别是在有限的软克霍夫导管的环境中.
- 炎风险随着累积的PD持续时间和重复的导管插入而升级.
- 仔细监测和遵守会话限制对于减轻并发症至关重要.
相关概念视频
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
1.3K
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
1.3K
01:20Acute Kidney Injury V: Interprofessional Care
438
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
438
01:25Peritoneal Dialysis III: Nursing Management
1.2K
Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
1.2K
01:30Continuous Renal Replacement Therapy
1.5K
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
1.5K
01:30Peritoneal Dialysis I: Introduction and Procedure
5.0K
Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
5.0K
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
1.3K
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
1.3K