早期液体过载和儿科重症监护室临床结果之间的关联
Sangeetha B Rao1,2, Alireza Akhondi-Asl3,4, Nilesh Mehta3,4
1Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Department of Anaesthesia, Harvard Medical School, Boston, MA, USA. sangeetha.rao@childrens.harvard.edu.
Pediatric research
|June 25, 2025
概括
在入住儿科混合医疗外科ICU的重症儿童中,流体过载 (FO) 是常见的,并且与更糟糕的结果有关. 针对特定流体类型的干预措施可以减少FO并改善患者的结果.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 腎臟病學 (nephrology) 是一種醫學專業.
- 密集护理研究 密集护理研究
背景情况:
- 流体过载 (FO) 是重症儿童的一个潜在问题.
- 了解FO发生率和贡献者对于改善结果至关重要.
研究的目的:
- 为了确定儿童ICU入院后48小时内累积FO的发生率和贡献者.
- 评估FO与该人群的临床结果之间的关联.
主要方法:
- 对接受儿科MSICU治疗的儿童 (0-18岁) 的回顾性观察队列研究 (2017-2022年).
- 在48小时后分析FO百分比和液体组成.
- FO与临床结果的相关性,包括ICU停留时间,AKI和无呼吸器日.
主要成果:
- 在3013名患者中,有19%的患者经历了严重的FO (>10%).
- 严重的FO与年轻的年龄和更高的维护IV液体给药有关.
- 中度和重度的FO与加长ICU停留时间,急性损伤 (AKI) 的更高几率以及在28日 (VFD28) 的无呼吸器日数更少相关.
结论:
- 48小时后严重的FO在儿科ICU中很普遍,并与不良的临床结果相关.
- FO受多种可修改的液体亚型的影响,特别是在最初的24小时之后.
- 对减轻FO干预措施的进一步研究是有必要的,以改善患者的治疗结果.
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