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[德国急性肾衰竭的治疗:结构分析]

[Treatment of acute renal failure in Germany: a structural analysis].

作者信息

Schindler R, Hutagalung R, Jörres A, John S, Quintel M I, Brunkhorst F M, Heering P

机构信息

Medizinische Klinik m.S. Nephrologie und Internistische Intensivmedizin, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum.

Zentrum für Klinische Studien, Paul-Martini-FG Klinische Sepsisforschung; Klinik für Anästhesiologie, und Intensivtherapie, Universitätsklinikum Jena.

出版信息

Dtsch Med Wochenschr. 2014 Aug;139(34-35):1701-6. doi: 10.1055/s-0034-1370272. Epub 2014 Aug 12.

Abstract

INTRODUCTION

There are no reliable data on the structure and practice of the care of critically ill patients with acute renal failure in Germany.

METHODS

We carried out a detailed survey by sending a questionnaire to 2265 German Intensive Care Units. The questionnaire contained 19 questions regarding renal replacement therapy.

RESULTS

423 German intensive care units participated in the survey. Most of the ICUs are headed interdisciplinary (47%) or by anesthesiologists (30%), with significant differences depending on the size of the clinic, with primarily interdisciplinary management in smaller clinics. The offered type of renal replacement therapy varies significantly, the smaller the house the fewer methods are available. Thus, intermittent dialysis procedures are offered only in 35% of hospitals with up to 400 beds. The indication for the initiation of acute renal replacement therapy in intensive care is provided predominantly (53%) by an anesthesiologist. A nephrologist is only involved in 22% of all intensive care units. The indication is based primarily on a "clinical criteria", but these are poorly defined.

CONCLUSION

Our results demonstrate the need for cross-disciplinary standards for the treatment of acute renal failure in German intensive care units.

摘要

引言

在德国,关于急性肾衰竭重症患者护理的结构和实践,尚无可靠数据。

方法

我们向2265个德国重症监护病房发送问卷进行了详细调查。问卷包含19个关于肾脏替代治疗的问题。

结果

423个德国重症监护病房参与了调查。大多数重症监护病房由多学科团队领导(47%)或由麻醉医生领导(30%),这因诊所规模而异,小诊所主要采用多学科管理。所提供的肾脏替代治疗类型差异很大,规模越小的医院可用方法越少。因此,在床位多达400张的医院中,只有35%提供间歇性透析程序。重症监护中急性肾脏替代治疗开始的指征主要由麻醉医生确定(53%)。只有22%的重症监护病房有肾病科医生参与。该指征主要基于“临床标准”,但这些标准定义不明确。

结论

我们的结果表明,德国重症监护病房需要针对急性肾衰竭治疗制定跨学科标准。

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