Maxwell Robert A, Bell Christopher Michael
Department of Surgery, University of Tennessee College of Medicine, Chattanooga, Chattanooga, TN, USA.
Department of Surgery, University of Tennessee College of Medicine, Chattanooga, Chattanooga, TN, USA.
Surg Clin North Am. 2017 Dec;97(6):1399-1418. doi: 10.1016/j.suc.2017.07.004.
Acute kidney injury (AKI) occurs frequently in the surgical intensive care unit and results in significant morbidity and mortality. AKI needs to be identified early and underlying causes treated or eliminated. Sepsis, major surgery such as coronary artery bypass, and hypovolemia are the most common causes and patients with underlying comorbidities have increased susceptibility. Treatment should begin by ensuring that patients are adequately resuscitated and all contributing causes are replaced or eliminated. After stabilization of hemodynamic status and elimination of contributing causes, treatment becomes largely supportive and may require the use of a renal replacement therapy.
急性肾损伤（AKI）在外科重症监护病房中频繁发生，并导致显著的发病率和死亡率。需要尽早识别AKI并治疗或消除潜在病因。脓毒症、冠状动脉搭桥等大手术以及血容量不足是最常见的病因，有基础合并症的患者易感性增加。治疗应首先确保患者得到充分复苏，并纠正或消除所有相关病因。在血流动力学状态稳定且相关病因消除后，治疗主要是支持性的，可能需要使用肾脏替代疗法。
