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吸入一氧化氮疗法与肺移植患者术后急性肾损伤无关:一项回顾性试点研究。

Inhaled nitric oxide therapy was not associated with postoperative acute kidney injury in patients undergoing lung transplantation: A retrospective pilot study.

作者信息

Ri Hyun-Su, Son Hyo Jung, Oh Han Byeol, Kim Su-Young, Park Ju Yeon, Kim Ju Yeon, Choi Yoon Ji

机构信息

Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan Department of Anesthesiology and Pain Medicine, National Police Hospital, Seoul, Korea.

出版信息

Medicine (Baltimore). 2018 Jun;97(22):e10915. doi: 10.1097/MD.0000000000010915.

Abstract

Inhaled nitric oxide (iNO) therapy is commonly used in lung transplantation (LT) recipients during the perioperative periods. However, previous studies report that the use of iNO may increase the risk of renal dysfunction. Post-LT acute kidney injury (AKI) can lead to critical situations, including prolonged intensive care unit or hospital stays and increased morbidity and mortality. Accordingly, the aim of this study was to investigate the relationship between iNO therapy and incidence of post-LT AKI in LT recipients.The medical data of 36 patients who underwent LT surgery from January 2012 to July 2017 in a single university hospital setting were retrospectively collected and analyzed. Patients were divided into 2 groups: iNO (n = 14) and control (n = 19). The demographic data, anesthetic methods, complications, and perioperative laboratory test values of each patient were assessed. Patients were categorized according to changes in plasma creatinine (Cr) concentration levels within 48 hours after LT using Acute Kidney Injury Network criteria.There was no significant difference in the occurrence (P = .13) and severity (P = .9) of post-LT AKI between iNO and control groups. The mean serum Cr levels after surgery were 0.91 ± 0.44 and 0.81 ± 0.37 mg/dL in the iNO and control groups, respectively (P = .50).AKI plays a critical role in the prognosis of LT recipients. Our results revealed that iNO therapy was not associated with the incidence of post-LT AKI. Therefore, if iNO treatment is indicated, active use under close monitoring of renal function is recommended in LT-patients concerned about AKI after surgery.

摘要

吸入一氧化氮(iNO)疗法常用于肺移植(LT)受者的围手术期。然而,先前的研究报告称,使用iNO可能会增加肾功能不全的风险。LT术后急性肾损伤(AKI)可导致危急情况,包括延长重症监护病房或住院时间以及增加发病率和死亡率。因此,本研究的目的是调查iNO疗法与LT受者术后AKI发生率之间的关系。回顾性收集并分析了2012年1月至2017年7月在一家大学医院接受LT手术的36例患者的医疗数据。患者分为两组:iNO组(n = 14)和对照组(n = 19)。评估了每位患者的人口统计学数据、麻醉方法、并发症和围手术期实验室检查值。根据LT术后48小时内血浆肌酐(Cr)浓度水平的变化,使用急性肾损伤网络标准对患者进行分类。iNO组和对照组之间LT术后AKI的发生率(P = 0.13)和严重程度(P = 0.9)无显著差异。iNO组和对照组术后平均血清Cr水平分别为0.91±0.44和0.81±0.37mg/dL(P = 0.50)。AKI在LT受者的预后中起关键作用。我们的结果显示,iNO疗法与LT术后AKI的发生率无关。因此,如果需要进行iNO治疗,建议在密切监测肾功能的情况下,对术后担心发生AKI的LT患者积极使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d76d/6392543/38a2d940b29c/medi-97-e10915-g001.jpg

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