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Ann Intensive Care:急性肾损伤持续时间对重症患者短期结局有何影响?

2018-03-23 徐晓涵 环球医学网

发表于《Ann Intensive Care》上的一项研究,考察了重症急性患者急性肾损伤(AKI)的持续时间与短期结局的相关性。

发表于《Ann Intensive Care》上的一项研究,考察了重症急性患者急性肾损伤(AKI)的持续时间与短期结局的相关性。

背景:AKI持续时间被认为是AKI后不良结局的风险因素。研究者旨在探究AKI持续时间和复发与符合急性呼吸窘迫综合征条件的机械通气的重症患者短期结局的关系。

方法:NHLBI ARDS网络SAILS多中心试验中,发生AKI的参与者纳入到本分析中,并基于AKI持续时间分组。使用t检验和卡方检验评估结局的差异。竞争风险回归和Cox回归用于评估与AKI缓解和AKI复发相关的因素。

结果:总共238例患者纳入研究。77例患者具有较短AKI病程(1~2天),47例中等病程(3~7天),87例持续AKI(>7天),38例AKI期间死亡。持续AKI与较差的结局相关,包括ICU住院延长、机械通气时间的延长和心血管衰竭的天数延长。短期和中期病程的AKI患者无临床差异,甚至在考虑了AKI严重程度和AKI复发后亦是如此。在满足AKI标准的当天,AKI缓解的患者发生少尿或中度/重度ARDS的可能性较低。AKI复发与较差的临床结局相关。无基线临床因素可预测AKI复发。

结论:脓毒症相关的ARDS和AKI重症患者中,短期和中期AKI病程对临床结局的影响适中。持续和复发性AKI都与较差的临床结局相关,这强调了识别可从新型干预中获益的患者的重要性。

原始出处:
Federspiel CK, Itenov TS, Mehta K,et al.Duration of acute kidney injury in critically ill patients.Ann Intensive Care. 2018 Feb 23;8(1):30. doi: 10.1186/s13613-018-0374-x.

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    2018-03-25 zhwj
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    2018-03-24 张新亮1853311252142e2fm

    好文献.谢谢

    0

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