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Chest：尿量的强化监测与增加急性肾损伤的检测和改善预后有关

2017-05-26 xing.T MedSci原创

尿量强化监测AKI预后
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在大型ICU人群中，强化UO监测与改善的AKI检测相关，并且可以降低发生AKI患者以及较少的液体超负荷的患者的30天死亡率。该研究结果应该有助于指导临床决策和ICU政策，关于监测UO频率，尤其是AKI和/或液体超负荷的高危患者。

尿量（UO）是危重患者一项重要生命体征，但是在不同ICUs之间UO的监测和报告标准有很大的不同。仔细进行UO监测可能导致早期识别急性肾损伤（AKI）和更好地进行液体管理。近日，呼吸领域权威杂志chest上发表了一篇研究文章，研究人员试图确定加强UO监测是否与有与无AKI的患者预后相关。

研究人员进行了一项回顾性队列研究，纳入了15724名在2000年至2008年期间入住ICU的成年患者。强化UO监测被定义为ICU入住后每小时的记录，并且前48小时内不间断超过3小时。

4049（26%）例患者接受了强化UO监测，研究人员发现在这些患者中AKI发生率明显升高（比值比为1.22，P＜0.001）。对年龄与疾病的严重程度进行调整后，强化UO监测与改善生存相关，但只有在发生AKI的患者中。无论伴有或不伴有AKI，在ICU停留的第一个72小时，强化监测的患者也有更少的累积液体体积（2.98L vs. 3.78L，P＜0.001）和较少的液体超负荷（2.49% vs. 5.68%，P＜0.001）。

在大型ICU人群中，强化UO监测与改善的AKI检测相关，并且可以降低发生AKI患者以及较少的液体超负荷的患者的30天死亡率。该研究结果应该有助于指导临床决策和ICU政策，关于监测UO频率，尤其是AKI和/或液体超负荷的高危患者。

原始出处：

Kui Jin.et al. Intensive Monitoring of Urine Output is Associated with Increased Detection of Acute Kidney Injury and Improved Outcomes.chest.2017. http://journal.publications.chestnet.org/article.aspx?articleid=2629214

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    2017-09-12 Smile2680

    #Chest#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1929344, encodeId=1865192934400, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Tue Sep 12 01:34:00 CST 2017, time=2017-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050701, encodeId=8b752050e0173, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Tue Dec 19 20:34:00 CST 2017, time=2017-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397199, encodeId=4494139e199c0, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat May 27 23:34:00 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202715, encodeId=367f202e15d0, content=文章很好，拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri May 26 08:46:06 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-12-19 xiangyuzhou971

    #EST#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1929344, encodeId=1865192934400, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Tue Sep 12 01:34:00 CST 2017, time=2017-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050701, encodeId=8b752050e0173, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Tue Dec 19 20:34:00 CST 2017, time=2017-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397199, encodeId=4494139e199c0, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat May 27 23:34:00 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202715, encodeId=367f202e15d0, content=文章很好，拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri May 26 08:46:06 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-05-27 ms3046638856685384

    #损伤#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1929344, encodeId=1865192934400, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Tue Sep 12 01:34:00 CST 2017, time=2017-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050701, encodeId=8b752050e0173, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Tue Dec 19 20:34:00 CST 2017, time=2017-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1397199, encodeId=4494139e199c0, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sat May 27 23:34:00 CST 2017, time=2017-05-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=202715, encodeId=367f202e15d0, content=文章很好，拜读了, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri May 26 08:46:06 CST 2017, time=2017-05-26, status=1, ipAttribution=)]
    2017-05-26 1e10c84am36(暂无匿称)

    文章很好，拜读了

    0

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