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危重症患者连续性肾脏替代治疗的预后因素和疗效:一项中国单中心回顾性研究。

Prognostic Factors and Efficacy for Continuous Renal Replacement Therapy in Critically Ill Patients: A Chinese Single-Center Retrospective Study.

出版信息

Blood Purif. 2018;45(1-3):53-60. doi: 10.1159/000481769. Epub 2017 Dec 7.

Abstract

BACKGROUND

There is controversy about the efficacy and prognostic factors for continuous renal replacement therapy (CRRT) in China due to practice variation. Our aim is to investigate these questions.

METHOD

A total of 613 adult patients receiving CRRT in last 3 years from one Chinese ICU were enrolled. The analysis of demographic data, vital signs, and laboratory tests prior to CRRT and outcomes were performed. The data between pre- and post-CRRT were compared for efficacy analysis.

RESULTS

Prior to CRRT, partial pressure of carbon dioxide (PCO2), systolic blood pressure (SBP), gender, age, bilirubin, cystatin C, and mechanical ventilation were correlated with in-hospital mortality. In a binary logistic regression, PCO2, SBP, age, and gender were significant in predicting mortality. Cox regression analysis demonstrated PCO2 independent association with mortality, and lower SBP worse mortality. CRRT could eliminate the fluid and metabolites.

CONCLUSION

CO2 retention and low SBP prior to CRRT were associated with increased mortality. CRRT significantly improved hemeostasis.

摘要

背景

由于实践差异,中国对于连续性肾脏替代治疗(CRRT)的疗效和预后因素存在争议。我们旨在探讨这些问题。

方法

共纳入 613 名过去 3 年在中国 ICU 接受 CRRT 的成年患者。对 CRRT 前的人口统计学数据、生命体征和实验室检查以及结果进行分析。比较了 CRRT 前后的数据以进行疗效分析。

结果

在 CRRT 前,二氧化碳分压(PCO2)、收缩压(SBP)、性别、年龄、胆红素、胱抑素 C 和机械通气与住院死亡率相关。在二元逻辑回归中,PCO2、SBP、年龄和性别是预测死亡率的重要因素。Cox 回归分析表明 PCO2 与死亡率独立相关,而较低的 SBP 与死亡率增加相关。CRRT 可以清除液体和代谢产物。

结论

CRRT 前的 CO2 潴留和 SBP 降低与死亡率增加相关。CRRT 显著改善了血液动力学稳定性。

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