Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University and Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, and The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine. 79 Qingchun Road, Hangzhou, China.
Department of Nephrology, The Fourth Affiliated Hospital, College of Medicine, Zhejiang University, N1 Shangcheng Road, Yiwu, China.
Biomed Res Int. 2019 Jul 2;2019:6392751. doi: 10.1155/2019/6392751. eCollection 2019.
The aim of this study was to identify the blood potassium level beneficial to the postoperative recovery of gastrointestinal motility during continuous renal replacement therapy (CRRT) in patient undergoing open abdominal surgery.
538 critically ill patients after open abdominal surgery and receiving CRRT were retrospectively recruited as the study cohort. Demographic and clinical data were recorded along with an evaluation of the postoperative gastrointestinal motility.
Correlation analysis was used to assess the correlation coefficient, and then the variables with correlation coefficient value less than 0.5 were included in the binary logistic regression model. Binary logistic regression model indicated that the postoperative blood potassium level was independently associated with the recovery of gastrointestinal motility (OR=0.109, 95% CI= 0.063 to 0.190, p<0.001). Based on the normal range of blood potassium level, we selected the cut-off point of blood potassium level via Weight of Evidence analysis, which was 4.00 mmol/L. Compared with the patients with insufficient blood potassium levels (plasma potassium concentration < 4.00 mmol/L), those with sufficient blood potassium levels (plasma potassium concentration≥ 4.00 mmol/L) conferred an increase in the rate of 4-day postoperative recovery of gastrointestinal motility (OR= 4.425, 95% CI = 2.933 to 6.667, p<0.001).
Maintaining the blood potassium concentrations at a relatively high level of the normal blood potassium range during CRRT would be beneficial to postoperative recovery of gastrointestinal motility.
本研究旨在确定在接受开放性腹部手术后进行连续肾脏替代治疗（CRRT）期间有利于胃肠道动力术后恢复的血钾水平。
回顾性招募了 538 例接受开放性腹部手术后并接受 CRRT 的危重症患者作为研究队列。记录了人口统计学和临床数据，并评估了术后胃肠道动力。
使用相关分析评估相关系数，然后将相关系数值小于 0.5 的变量纳入二元逻辑回归模型。二元逻辑回归模型表明，术后血钾水平与胃肠道动力恢复独立相关（OR=0.109，95%CI=0.063 至 0.190，p<0.001）。基于血钾水平的正常范围，我们通过证据权重分析选择血钾水平的截止值，即 4.00mmol/L。与血钾水平不足的患者（血浆钾浓度<4.00mmol/L）相比，血钾水平充足的患者（血浆钾浓度≥4.00mmol/L）术后 4 天胃肠道动力恢复率增加（OR=4.425，95%CI=2.933 至 6.667，p<0.001）。
在 CRRT 期间将血钾浓度维持在正常血钾范围的相对较高水平有利于术后胃肠道动力的恢复。
