急性肾损伤(acute kidney injury, AKI)是心脏术后常见并发症之一,不仅增加重症监护室(intensive care unit, ICU)住院时间以及医疗费用,而且增加了术后患者的死亡率。连续肾脏替代治疗(continuous renal replacement therapy, CRRT)是ICU中肾脏替代治疗(renal replacement therapy, RRT)的主要形式,CRRT具有精确容量控制、稳定酸碱平衡、纠正电解质紊乱、血流动力学稳定等优点。对于AKI伴有危及生命并发症的患者启动CRRT的决定相对简单,然而在没有明确紧急适应症的情况下,开始CRRT的最佳时机仍存在争议。
Acute kidney injury (AKI) is one of the common complications after cardiac surgery, which not only increases the length of stay in intensive care unit (ICU) and medical costs, but also increases the mortality of patients after surgery. Continuous renal replacement therapy (CRRT) is the main form of renal replacement therapy (RRT) in ICU. CRRT has the advantages of accurate volume control, stable acid-base balance, correction of electrolyte disorders, and hemodynamic stability. The deci-sion to initiate CRRT in patients with AKI with life-threatening complications is relatively straight-forward; however, the optimal timing for initiating CRRT in the absence of clear emergency indica-tions remains controversial.
心脏手术,急性肾损伤,连续肾脏替代治疗, Cardiac Surgery Acute Kidney Injury Continuous Renal Replacement Therapy摘要
急性肾损伤(acute kidney injury, AKI)是心脏术后常见并发症之一,不仅增加重症监护室(intensive care unit, ICU)住院时间以及医疗费用,而且增加了术后患者的死亡率。连续肾脏替代治疗(continuous renal replacement therapy, CRRT)是ICU中肾脏替代治疗(renal replacement therapy, RRT)的主要形式,CRRT具有精确容量控制、稳定酸碱平衡、纠正电解质紊乱、血流动力学稳定等优点。对于AKI伴有危及生命并发症的患者启动CRRT的决定相对简单,然而在没有明确紧急适应症的情况下,开始CRRT的最佳时机仍存在争议。
关键词
心脏手术,急性肾损伤,连续肾脏替代治疗
Progress on the Timing of Early Initiation of Continuous Renal Replacement Therapy for Acute Kidney Injury after Cardiac Surgery
Suijiao Wei1, Jing Jiao1, Peng Zhang2*
1Xi’an Medical University, Xi’an Shaanxi
2Department of Nephrology, Xijing Hospital, Air Force Medical University, Xi’an Shaanxi
Acute kidney injury (AKI) is one of the common complications after cardiac surgery, which not only increases the length of stay in intensive care unit (ICU) and medical costs, but also increases the mortality of patients after surgery. Continuous renal replacement therapy (CRRT) is the main form of renal replacement therapy (RRT) in ICU. CRRT has the advantages of accurate volume control, stable acid-base balance, correction of electrolyte disorders, and hemodynamic stability. The decision to initiate CRRT in patients with AKI with life-threatening complications is relatively straightforward; however, the optimal timing for initiating CRRT in the absence of clear emergency indications remains controversial.
魏岁姣,焦 晶,张 鹏. 心脏术后急性肾损伤早期启动连续肾脏替代治疗时机的研究进展Progress on the Timing of Early Initiation of Continuous Renal Replacement Therapy for Acute Kidney Injury after Cardiac Surgery[J]. 临床医学进展, 2022, 12(10): 9125-9131. https://doi.org/10.12677/ACM.2022.12101319
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