儿科重症监护室的败血症相关的急性损伤:频率和结果
Anosha Muhammad Aslam1,2, Wasif Ilyas Vohra1,2, Ariba Siddiqui1,2
1Department of Paediatrics, The Aga Khan University Hospital, Karachi, Pakistan.
概括
儿科重症监护室 (PICU) 的败血症相关急性损伤与更长的住院时间和增加的死亡率有关. 早期发现和治疗S-AKI对于改善重症儿童的治疗结果至关重要.
科学领域:
- 儿童重症监护医疗
- 肝脏病学
- 感染性疾病
背景情况:
- 败血症是一种危及生命的器官功能障碍,
- 急性损伤 (AKI) 是重症儿童的常见并发症,特别是毒症儿童.
- 败血症相关的AKI (S-AKI) 在儿科重症监护室 (PICU) 的诊断和管理中提出了独特的挑战.
研究的目的:
- 确定S-AKI诊断的儿科患者的发病率和短期结果.
- 在PICU群体中分析与S-AKI发展相关的因素.
- 评估S-AKI对PICU停留时间和死亡率的影响.
主要方法:
- 在2021年1月至2022年6月期间,在儿科重症监护室 (PICU) 进行了横截面研究.
- 使用p- RIFLE标准评估了患有败血症的儿科患者 (1个月至18岁).
- 数据分析包括基平方测试和后勤回归,以确定变量与S-AKI之间的关联.
主要成果:
- 在符合纳入标准的323名败血症患者中,56名 (17. 3%) 患有AKI.
- 患有S- AKI的患者平均在PICU停留时间较长 (7. 04天对比5. 24天),死亡率较高 (39. 22%对比20. 59%).
- 低血压,寡尿症,血尿酸 (BUN) 的升高,以及代谢性酸化与S-AKI有显著的关联.
结论:
- 与败血症相关的AKI是PICU中的重大并发症,与短期不良结果相关.
- 患有S-AKI的儿童面临长时间的PICU住院和大幅增加的死亡风险.
- 这些发现强调了儿童感染感染的警监测和及时干预的重要性.
相关概念视频
01:22Acute Kidney Injury I: Introduction
72
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
72
01:29Acute Kidney Injury III: Clinical Manifestations
91
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
91
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
57
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
57
01:20Acute Kidney Injury V: Interprofessional Care
44
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...
44
01:29Acute Kidney Injury II: Pathophysiology
72
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
72
01:22Acute Kidney Injury VI: Nursing Management
57
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
57