小儿心脏重症监护中的急性肾损伤与心肾综合征
Acute Kidney Injury and Cardiorenal Syndromes in Pediatric Cardiac Intensive Care.
作者信息
Cooper David S, Kwiatkowski David M, Goldstein Stuart L, Krawczeski Catherine D
机构信息
1Department of Pediatrics, Section of Cardiology, University of Cincinnati College of Medicine, Cardiac Intensive Care Unit, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 2Department of Pediatrics, Section of Cardiology, Stanford University School of Medicine, Lucile Packard Children's Hospital, Palo Alto, CA. 3Department of Pediatrics, Section of Nephrology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 4Department of Pediatrics, Section of Cardiology, Stanford University School of Medicine, Cardiac Intensive Care Unit, Lucile Packard Children's Hospital Palo Alto, CA.
出版信息
Pediatr Crit Care Med. 2016 Aug;17(8 Suppl 1):S250-6. doi: 10.1097/PCC.0000000000000820.
OBJECTIVES
The objectives of this review are to discuss the definition, diagnosis, and pathophysiology of acute kidney injury and its impact on immediate, short-, and long-term outcomes. In addition, the spectrum of cardiorenal syndromes will be reviewed including the pathophysiology on this interaction and its impact on outcomes.
DATA SOURCE
MEDLINE and PubMed.
CONCLUSION
The field of cardiac intensive care continues to advance in tandem with congenital heart surgery. As mortality has become a rare occurrence, the focus of cardiac intensive care has shifted to that of morbidity reduction. Acute kidney injury adversely impact outcomes of patients following surgery for congenital heart disease as well as in those with heart failure (cardiorenal syndrome). Patients who become fluid overloaded and/or require dialysis are at a higher risk of mortality, but even minor degrees of acute kidney injury portend a significant increase in mortality and morbidity. Clinicians continue to seek methods of early diagnosis and risk stratification of acute kidney injury to prevent its adverse sequelae.
目的
本综述的目的是讨论急性肾损伤的定义、诊断、病理生理学及其对即刻、短期和长期预后的影响。此外，还将综述心肾综合征的范围，包括这种相互作用的病理生理学及其对预后的影响。
数据来源
医学文献数据库（MEDLINE）和医学期刊数据库（PubMed）。
结论
心脏重症监护领域随着先天性心脏病手术的发展而不断进步。由于死亡率已很少见，心脏重症监护的重点已转向降低发病率。急性肾损伤对先天性心脏病手术后的患者以及心力衰竭（心肾综合征）患者的预后产生不利影响。出现液体超负荷和/或需要透析的患者死亡风险更高，但即使是轻度急性肾损伤也预示着死亡率和发病率会显著增加。临床医生继续寻求急性肾损伤的早期诊断和风险分层方法，以预防其不良后果。
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