过量的常规超过体积增加了术后心脏手术相关急性损伤的风险
Han Zhang1, Jing Wang1, Tianlong Wang1
1Department of Cardiopulmonary Bypass, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Beijing, China.
Kidney diseases (Basel, Switzerland)
|February 2, 2026
概括
在心脏手术期间,传统超过 (CUF) 的较高容量增加了急性损伤的风险. 过度的CUF也与长时间通风相关,但不会减少红细胞输血,建议谨慎使用.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
背景情况:
- 常规超过 (CUF) 是心肺绕道术期间用于流体管理和血液成分度的标准程序.
- 与心脏手术相关的急性损伤 (CSA-AKI) 仍然是一个重要的并发症,需要对可修改的风险因素进行研究.
研究的目的:
- 调查常规超过量与术后CSA-AKI发生率之间的关联.
- 评估CUF数量对其他外科外科外科结果的影响.
主要方法:
- 追溯分析了22,403名在2018-2023年期间接受了心脏手术的成年患者.
- 患者根据体重调整后的CUF体积三分位数分为不同的群体.
- 多变量后勤回归和受限制的立方线被用于评估结果,包括CSA-AKI (KDIGO标准),输血需求和通风持续时间.
主要成果:
- CSA-AKI的发生率为28.1%.
- 体重调整后CUF体积增加独立地与任何阶段CSA-AKI (aOR 1.25) 和阶段2/3 CSA-AKI (aOR 1.42) 的更高风险相关.
- 在CUF量和CSA-AKI之间观察到非线性,J形关系. 较高的CUF体积与增加的机械通风和红细胞输血相关.
结论:
- 过重调整的常规超容量与心脏手术后CSA-AKI的更高发病率和长时间的机械通风有关.
- CUF并没有证明手术期间红细胞输血需求有所减少.
- 研究结果表明,在心脏手术患者的流体管理策略中,需要仔细考虑和明智地应用CUF.
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