富罗塞米德应激测试在患有急性损伤风险的儿童中使用
Imogen Clover-Brown1, Giovanni Ceschia2, Katja M Gist3
1Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Kidney international reports
|December 22, 2025
概括
罗塞米德压力测试 (FST) 可以预测严重的急性损伤 (AKI) 和需要替代疗法 (RRT) 在高风险的儿科重症监护室 (PICU) 患者. 来自FST的尿流率 (UFR) 是一个有价值的预测指标,即使在已建立的AKI.
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
- 脏生理学 脏生理学
背景情况:
- 罗塞米德压力测试 (FST) 评估罗塞米德后的尿液流速 (UFR).
- FST是为了预测严重急性损伤 (AKI) 和成人需要替代疗法 (RRT) 而建立的.
- 关于儿科重症监护室 (PICU) 患者的FST实用性的数据有限,特别是那些使用痛指数 (RAI) 和尿中性粒细胞凝酶相关性脂卡林 (uNGAL) 进行高风险分层的患者.
研究的目的:
- 评估FST在预测高风险PICU患者严重AKI和RRT接收方面的预后性表现.
- 评估从FST获得的尿液流速 (UFR) 的预测值,以评估不良结局.
- 为了确定FST是否在这个人群中具有独立于AKI阶段的预后效用.
主要方法:
- 结合了两项高风险PICU患者前性观察研究 (RAI+和uNGAL+) 的数据.
- 在第一周内接受FST的患者和没有接受FST的患者之间的结果进行了比较.
- 分析了FST响应者与非响应者,检查了UFR在2天内新发或持续严重AKI或RRT接收的预测性表现.
主要成果:
- 在273名高风险患者中,112人接受了FST;60%的患者没有反应.
- 与响应者相比,FST非响应者具有更高的AKI阶段,并且新的/持续严重AKI (89%vs. 37%) 和RRT接收 (43%vs. 8%) 的发生率明显更高.
- 对于严重的AKI (AUROC:0.89) 和RRT接收 (AUROC:0.84),UFR表现出强大的预测性能,并确定了最佳切断点.
结论:
- FST在高风险儿科群体中不一致地应用,但提供了重要的预后信息.
- 来自FST的UFR有效地预测了PICU患者新的或持续的严重AKI和RRT接收.
- 对于严重的AKI和RRT,FST的预后效用独立于最初的AKI阶段.
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