HOW TO CHOOSE THE IDEAL RENAL REPLACEMENT THERAPY IN SEPSIS?
HOW TO CHOOSE THE IDEAL RENAL REPLACEMENT THERAPY IN SEPSIS?
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DOI：
10.1097/shk.0b013e31828fafa6
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发表时间：
2013-05-01
期刊：
影响因子：
3.1
通讯作者：
Durao, Marcelino de Souza, Jr.
中科院分区：
文献类型：
--
作者：
Filiponi, Thiago Corsi;Durao, Marcelino de Souza, Jr.
脓毒症是重症监护病房患者急性肾损伤(AKI)的主要原因。急性肾损伤是死亡率的独立危险因素，它的发生增加了治疗的复杂性和成本。然而，AKI的病理生理机制尚不清楚。涉及血流动力学、血管、肾小管、细胞、炎症和氧化过程。AKI患者通常有各种合并症，并且是老年人和高分解代谢者，需要使用血管加压剂和机械通气。透析是AKI的主要治疗方法。虽然没有任何特定的透析方式有明确的益处，但这些患者最初被指导使用持续透析方法，特别是对于有多器官系统功能障碍的最严重的病例和那些表现出血流动力学不稳定迹象的患者。最近的研究表明，患者应接受至少25mL.kg(-1).h(-1)的透析量。
Sepsis is the main cause of acute kidney injury (AKI) among individuals hospitalized in intensive care units. Acute kidney injury is an independent risk factor for mortality, and its occurrence increases the complexity and cost of treatment. However, the pathophysiological mechanisms of AKI remain unclear. Hemodynamic, vascular, tubular, cellular, inflammatory, and oxidative processes are involved. Individuals with AKI generally have various comorbidities and are elderly and hypercatabolic and on vasopressors and mechanical ventilation. Dialysis is the main treatment for AKI. Although there is no clear benefit of any specific dialysis modality, these patients are initially instructed to use continuous dialysis methods, especially for the most severe cases with multiple organ system dysfunctions and for those who display signs of hemodynamic instability. Recent studies demonstrate that patients should receive a dialysis dose of at least 25 mL.kg(-1).h(-1).