卡里指南:为改善脏移植结果的平衡电解质溶液提供基于证据的建议
Colm O'Reilly1,2, David Tunnicliffe1,2, Allan Blackley3
1Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Kidney international reports
|August 15, 2025
概括
均衡的电解质溶液显著降低了移植中延迟的移植功能,特别是来自已故捐赠者的移植. 虽然它们对高血症的影响尚不清楚,但它们被推用于已故供体移植.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植医学 移植医学
- 关键的护理关键的护理
背景情况:
- 延迟移植功能 (DGF) 影响到40%的已故捐赠移植患者.
- 在移植中使用正常的盐水引起了对DGF和超性代谢性酸性疾病的担忧.
- 建议使用平衡电解质溶液 (BES) 来缓解DGF,但也引发了高血症的担忧.
研究的目的:
- 综合关于BES与正常盐水在脏移植中的使用证据.
- 为澳大利亚和新西兰的护理提供建议.
- 评估BES对DGF和高血症的影响.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 包括来自BEST流体试验的数据.
- 证据评估的确定性等级和证据到决策框架.
主要成果:
- 与正常盐水相比,BES可以将DGF降低18% (RR 0.82;95%CI:0.71-0.94).
- 已故供体移植显示,BES显著减少了DGF (每1000人减少69人).
- 对死者和活体捐赠者移植的高卡利米亚的影响尚不清楚.
结论:
- 对于已故的捐赠者脏移植,由于证据的适度确定性减少了DGF,因此建议使用BES.
- 在低证据确定性的情况下,BES被建议用于活体供体移植.
- 需要进一步研究以患者为中心的结果和儿科使用.
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