回顾性分析：危重症儿童肾脏替代治疗的结局。

A retrospective analysis: the outcome of renal replacement therapies in critically ill children.

机构信息

Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Nephrology - Afyonkarahisar, Turkey.

Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care Unit - Afyonkarahisar, Turkey.

出版信息

Rev Assoc Med Bras (1992). 2023 May 15;69(6):e20220837. doi: 10.1590/1806-9282.20220837. eCollection 2023.

DOI:10.1590/1806-9282.20220837

PMID:37194900

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10185053/

Abstract

OBJECTIVE

A few pediatric studies were present which focused on renal replacement therapy used for critically ill children. This research aimed to determine the ratio of utilization of intermittent hemodialysis, continuous renal replacement therapy, and peritoneal dialysis, and to study the properties and outcomes of critically ill pediatric patients who underwent renal replacement therapy.

METHODS

Critically ill children admitted to the intensive care unit and received renal replacement therapy from February 2020 to May 2022 were included. The children were divided into three groups: hemodialysis, continuous renal replacement therapy, and peritoneal dialysis.

RESULTS

A total of 37 patients (22 boys and 15 girls) who received renal replacement therapy met the criteria for this study. Continuous renal replacement therapy was used in 43%, hemodialysis in 38%, and peritoneal dialysis in 19%. In all, 28 (73%) children survived and 9 (27%) died in intensive care unit. The mean systolic blood pressure was significantly lower among children who received continuous renal replacement therapy (p<0.001). The need for inotropic medications and a higher PRISM III score were found to be the greatest indicators of mortality.

CONCLUSION

The outcome of children receiving renal replacement therapy seems to be related to their needs for vasoactive drugs and the severity of the underlying disease in the continuous renal replacement therapy group relative to the other groups.

摘要

目的

有一些儿科研究集中在用于危重症儿童的肾脏替代治疗上。本研究旨在确定间歇性血液透析、连续肾脏替代治疗和腹膜透析的使用比例，并研究接受肾脏替代治疗的危重症儿科患者的特征和结局。

方法

纳入 2020 年 2 月至 2022 年 5 月期间入住重症监护病房并接受肾脏替代治疗的危重症儿童。将患儿分为三组：血液透析、连续肾脏替代治疗和腹膜透析。

结果

共有 37 名（22 名男孩和 15 名女孩）接受肾脏替代治疗的患儿符合本研究标准。连续肾脏替代治疗占 43%，血液透析占 38%，腹膜透析占 19%。共有 28 名（73%）患儿在重症监护病房存活，9 名（27%）患儿死亡。接受连续肾脏替代治疗的患儿的平均收缩压显著更低（p<0.001）。需要血管活性药物和更高的 PRISM III 评分是死亡率的最大指标。