Crit Care Med:儿童进行体外循环发生急性肾损伤的危险因素

2017-09-08 MedSci MedSci原创

近期,一项发表在杂志Crit Care Med上的研究旨在明确在接受体外循环心脏手术的婴幼儿中,无细胞血浆血红蛋白和急性肾损伤的关系。此项研究为前瞻性观察研究。受试患儿的入选标准为:大于1个月而少于18岁,手术需要体外循环,无预先存在的肾功能障碍。在基线(一个子集)、体外循环的开始和结束以及体外循环后2小时24小时收集60名受试者的血浆和尿液。体外循环期间血浆血红蛋白水平升高,并与体外循环持续时间

近期,一项发表在杂志Crit Care Med上的研究旨在明确在接受体外循环心脏手术的婴幼儿中,无细胞血浆血红蛋白和急性肾损伤的关系。此项研究为前瞻性观察研究。受试患儿的入选标准为:大于1个月而少于18岁,手术需要体外循环,无预先存在的肾功能障碍。在基线(一个子集)、体外循环的开始和结束以及体外循环后2小时24小时收集60名受试者的血浆和尿液。体外循环期间血浆血红蛋白水平升高,并与体外循环持续时间(R = 0.22)相关(p <0.01),体外循环结束后以及结束后的24小时出现结合珠蛋白的消耗(R = 0.12和0.15),乳酸脱氢酶水平的消耗(R = 0.27)和肌酐变化(R = 0.12)出现在体外循环结束。其中有43%的患者发生急性肾损伤。血浆血红蛋白水平与肌酐变化之间存在关联,并与年龄变化相关(总体[R = 0.12;p <0.01];年龄> 2岁[R = 0.22; p <0.01];而在<2岁[R = 0.03;p = 0.42])。此外,还发现血浆血红蛋白的变化和男性是急性肾损伤的危险因素(优势比分别为1.02和3.78;p <0.05

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