Uehara Kenji, Oya Sayako, Kameyama Miki, Terada Noriko, Yamaoka Masakazu, Takatori Makoto, Tada Keiichi
Masui. 2014 Mar;63(3):309-14.
Chronic hemodialysis patients undergoing surgery require intensive care. The purpose of this study was to determine the incidence and risk factors of emergency treatment before the planned elective postoperative dialysis.
One hundred and ten dialysis patients undergoing elective noncardiac surgery were retrospectively analyzed.
Emergency treatment was performed in 31 (28.1%) of the 110 patients, including one patient with emergency dialysis, because of hyperkalemia (n = 27) or metabolic acidosis (n = 4). Receiving operating characteristic curve analysis showed a cutoff value for serum potassium concentration < 4.0 mEq x l(-1) estimated by maximizing the Youden index. We could not find other perioperative data as significant risk factors for emergency treatment.
About 30 percent of dialysis patients aftet elective noncardiac surgery required emergency treatment. The highest risk was high serum potassium concentrations after induction of anesthesia Preoperative serum potassium concentrations should be kept below 4.0 mEq x l(-1) to avoid postoperative emergency treatment.
接受手术的慢性血液透析患者需要重症监护。本研究的目的是确定计划择期术后透析前紧急治疗的发生率和危险因素。
回顾性分析110例接受择期非心脏手术的透析患者。
110例患者中有31例（28.1%）接受了紧急治疗，其中1例患者因高钾血症（n = 27）或代谢性酸中毒（n = 4）进行了紧急透析。接受操作特征曲线分析显示，通过最大化约登指数估计血清钾浓度<4.0 mEq×l⁻¹为临界值。我们未发现其他围手术期数据是紧急治疗的显著危险因素。
约30%的透析患者在择期非心脏手术后需要紧急治疗。最高风险是麻醉诱导后血清钾浓度升高。术前血清钾浓度应保持在4.0 mEq×l⁻¹以下，以避免术后紧急治疗。
