Department of Medicine, National University Singapore, NUHS Tower Block, Level 10, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Cardiothoracic ICU, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
Crit Care. 2021 May 31;25(1):184. doi: 10.1186/s13054-021-03614-5.
The optimal timing of renal replacement therapy (RRT) in critically ill patients with acute kidney injury (AKI) has been much debated. Over the past five years several studies have provided new guidance for evidence-based decision-making. High-quality evidence now supports an approach of expectant management in critically ill patients with AKI, where RRT may be deferred up to 72 h unless a life-threatening indication develops. Nevertheless, physicians' judgment still plays a central role in identifying appropriate patients for expectant management.
在急性肾损伤 (AKI) 的危重症患者中,肾脏替代治疗 (RRT) 的最佳时机一直备受争议。在过去的五年中,多项研究为循证决策提供了新的指导。高质量的证据现在支持对 AKI 的危重症患者采取期待治疗的方法,除非出现危及生命的指征,否则 RRT 可能会延迟到 72 小时以后。然而,医生的判断在确定适合期待治疗的患者方面仍然起着核心作用。