Signa Vitae最新文献_第2页

Comparison of perineural brachial plexus block and proximal perivascular block in ultrasound-guided axillary brachial plexus block 超声引导下臂丛神经周围阻滞与近端血管周围阻滞的比较

4区医学

Signa Vitae Pub Date : 2023-01-01 DOI: 10.22514/sv.2023.082/

{"title":"Comparison of perineural brachial plexus block and proximal perivascular block in ultrasound-guided axillary brachial plexus block","authors":"","doi":"10.22514/sv.2023.082/","DOIUrl":"https://doi.org/10.22514/sv.2023.082/","url":null,"abstract":"The traditional axillary perineural (PN) approach for brachial plexus block is frequently used, but separate musculocutaneous nerve (MCN) block is required and increases procedure time and patient discomfort. We hypothesized that a block using the proximal perivascular (PPV) method at the MCN branching from the lateral cord would obviate the need for an MCN block while ensuring a quality similar to that of the PN method. For the PN group (n = 25), a needle was placed on each nerve, and 8 mL local anesthetic was infiltrated around the radial, ulnar, and median nerves (total: 24 mL). We then injected 6 mL local anesthetic around the MCN. In the PPV group (n = 25), we moved the probe proximally until the branching junction of the the MCN in the lateral cord. The needle tips were placed in the 12-o’clock and 6-o’clock positions of the axillary artery, and 15 mL local anesthetic was injected (total: 30 mL). The procedure time, number of needle passes, procedure-related complications, sensory/motor block level, and onset time were recorded. The PPV group had a significantly shorter procedure time than the PN group (3.9 ± 1.0 vs. 7.5 ± 3.3 min, p < 0.001). Furthermore, the PPV group required fewer needle passes. The PN group showed a significantly faster onset time than the PPV group (6.4 ± 2.7 vs. 10.4 ± 2.9 min, p < 0.001). The induction time did not show significant intergroup difference. Sensory blockade in the PN group occurred significantly faster than that in the PPV group at 5 and 10 min. There were no significant differences in motor nerve paralysis. PPV axillary block under ultrasound guidance was as effective as the PN axillary block. Therefore, the PPV axillary block is a simple, safe and effective regional technique for upper limb surgery.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135358837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mushroom intoxications presented to emergency departments in South Korea: a 2011‐2019 national registry study 韩国急诊科的蘑菇中毒:2011 - 2019年国家登记研究

4区医学

Signa Vitae Pub Date : 2023-01-01 DOI: 10.22514/sv.2023.086

{"title":"Mushroom intoxications presented to emergency departments in South Korea: a 2011‐2019 national registry study","authors":"","doi":"10.22514/sv.2023.086","DOIUrl":"https://doi.org/10.22514/sv.2023.086","url":null,"abstract":"This study aimed to investigate the association of characteristics and clinical outcomes of patients who presented with mushroom intoxication. We conducted a retrospective study of mushroom intoxication cases using national registry data (representative of the period 01 January 2011 to 31 December 2019). Specifically, we analyzed the demographics, vital signs, mental status, intoxication related factors, and clinical presentations of the patients. The outcomes were assessed based on general ward admission, intensive care unit (ICU) admission, length of hospitalization, and mortality. The t-test or chi-square test were used to compare the emergency department (ED) discharge group and admission group. Logistic regressions were used to predict patients that were high-risk with regards to being admitted. A total of 393 patients with mushroom intoxication were presented at the ED, and the highest number of visits occurred in the month of September. Overall, 277 (70.5%) patients were discharged from the ED and 116 (29.5%) patients were admitted. Of these, 25 (6.4%) patients were admitted to the ICU, and 3 (2.6%) patients died. Patients are more likely to be admitted to the general ward or ICU when symptoms presented after 6 h: 6 to 24 h (Odds ratio (OR) 2.158; 95% Confidence interval (CI), 1.218–3.816) or >24 h (OR: 3.382; 95% CI, 1.438–8.050). Additionally, when the patients presented with diarrhea, they were more likely to be discharged with favorable outcomes with a less likelihood for admission (OR: 0.237; 95% CI, 0.093–0.523). Most cases of mushroom intoxication presented with gastrointestinal symptoms and followed a benign course. The longer time to onset of symptoms increased the likelihood of hospitalization. Clinicians should evaluate more carefully, observe, or admit those with delayed symptom onset.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135361335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Femoral artery collapse ratio as an indicator of chest compression quality during cardiopulmonary resuscitation in a porcine cardiac arrest model 猪心脏骤停模型心肺复苏过程中，股动脉塌陷率作为胸按压质量的指标

4区医学

Signa Vitae Pub Date : 2023-01-01 DOI: 10.22514/sv.2023.102

{"title":"Femoral artery collapse ratio as an indicator of chest compression quality during cardiopulmonary resuscitation in a porcine cardiac arrest model","authors":"","doi":"10.22514/sv.2023.102","DOIUrl":"https://doi.org/10.22514/sv.2023.102","url":null,"abstract":"Cardiopulmonary resuscitation (CPR) quality is crucial for improving patient survival rates after cardiac arrest. This study aimed to investigate the usefulness of femoral artery collapse ratio (systolic diameter/diastolic diameter ratio) measurement using M-mode ultrasound versus end-tidal carbon dioxide (ETCO2) for the assessment of high-quality CPR in a porcine cardiac arrest model. A total of 10 male mongrel pigs (age range, 16–20 weeks; weight, 45–50 kg) were used. After anesthesia, the carotid artery was dissected and exposed. The animals were instrumented with an arterial catheter in the exposed carotid artery to monitor arterial blood pressure. Cardiac arrest was induced by injecting potassium chloride (KCl, 40 equivalents of weight). The animals underwent chest compression using a mechanical device, and the chest compression depth and ETCO2 were measured using a defibrillator. To obtain hemodynamic information, two investigators performed an ultrasound examination on both femoral arteries. One examiner measured the femoral peak systolic velocity (PSV), while the other measured the diameters of the femoral artery (systolic diameter and diastolic diameter) in a transverse or longitudinal position using the M-mode of the linear ultrasound probe. As the compression depth increased, ETCO2, femoral artery diameter, collapse ratio (systolic diameter/diastolic diameter), and blood flow increased; however, PSV decreased. The ETCO2 and collapse ratio were positively correlated. The femoral artery collapse ratio, measured using the M-mode ultrasound, could be an alternative and simple method to evaluate high-quality CPR.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135560241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of fibrinogen function by CFF-A10 in cardiac surgery 心脏手术中纤维蛋白原功能的CFF-A10评价

4区医学

Signa Vitae Pub Date : 2023-01-01 DOI: 10.22514/sv.2023.072

{"title":"Evaluation of fibrinogen function by CFF-A10 in cardiac surgery","authors":"","doi":"10.22514/sv.2023.072","DOIUrl":"https://doi.org/10.22514/sv.2023.072","url":null,"abstract":"Fibrinogen function is evaluated as the maximum amplitude (MA) of the citrated functional fibrinogen (CFF) assay in TEG6s®, however, CFF-MA requires a long time to obtain results. CFF-A10 (10-minute value), allowing more rapid decisions, however, no studies have evaluated the correlation between CFF-A10 levels and fibrinogen concentration. This study aimed to assess the correlation between CFF-A10 and blood fibrinogen levels measured using the dry hematology method after cardiopulmonary bypass (CPB). This retrospective study was conducted in a single university hospital and enrolled 192 patients of all ages who underwent cardiovascular surgery with CPB between 01 March 2020, and 05 November 2021. CFF-A10 and CFF-MA levels were measured using the TEG6s® global hemostasis assay, and blood fibrinogen levels were measured using the Fibcare® DRIHEMATO Fib-HSII after CPB. Simple linear regression analysis was used to evaluate the relationship between TEG6s® parameters and fibrinogen concentration. Furthermore, the patients were classified into four groups based on the cut-off values of fibrinogen at 150 mg/dL and CFF-A10, and the background factors for each group were analyzed. CFF-A10 and blood fibrinogen levels were correlated by linear regression (p < 0.0001, R2 = 0.37), similar to CFF-MA and fibrinogen levels (p < 0.0001, R2 = 0.40). The optimal cut-off value, which maximizes the sensitivity and specificity, of CFF-A10 for predicting low fibrinogen levels below 150 mg/dL, was 8.4 mm, with a sensitivity of 80.7% and specificity of 67.9%; that of CFF-MA was 9.2 mm, with a sensitivity of 76.3% and specificity of 69.8%. Despite sufficient blood fibrinogen levels, patients with low CFF-A10 levels experienced more postoperative bleeding. CFF-A10 predicted fibrinogen loss faster and with the same accuracy as CFF-MA did. Low CFF-A10 levels, despite sufficient fibrinogen levels, may be associated with increased blood loss following CPB.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135828097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

SESN1, as a potential target for postoperative cognitive dysfunction, attenuates sevoflurane-induced neuronal cell damage in the hippocampus SESN1作为术后认知功能障碍的潜在靶点，可减轻七氟醚诱导的海马神经元细胞损伤

4区医学

Signa Vitae Pub Date : 2023-01-01 DOI: 10.22514/sv.2023.107

{"title":"SESN1, as a potential target for postoperative cognitive dysfunction, attenuates sevoflurane-induced neuronal cell damage in the hippocampus","authors":"","doi":"10.22514/sv.2023.107","DOIUrl":"https://doi.org/10.22514/sv.2023.107","url":null,"abstract":"Postoperative cognitive dysfunction (POCD) is a devastating complication with long-term consequences, and new therapeutic targets and drugs are still needed for the treatment of POCD. Sestrin are a family of stress-inducing proteins that regulate cellular metabolic networks. However, the possible effects of Sestrin on POCD were still unclear. This study aimed to investigate the effects of Sestrin 1 (SESN1) in postoperative cognitive dysfunction (POCD) cell model and reveal its mechanism. We constructed an in vitro model of POCD by treating primary rat hippocampal neurons with sevoflurane. Herein, we noticed SESN1 enhanced cell viability induced by sevoflurane. Further, SESN1 improved sevoflurane-induced cell inflammation. We further found that SESN1 improved sevoflurane induced reactive oxygen species (ROS) production and inhibited apoptosis. Mechanically, SESN1 restrained NOD-like receptor thermal protein domain 3 (NLRP3) inflammasome activation and therefore suppressed POCD. In conclusion, SESN1, as a potential target for postoperative cognitive dysfunction, attenuates sevoflurane-induced neuronal cell damage in the hippocampus. These findings will provide guidance for the mechanism study of POCD and future drug development for treatment of POCD.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135560459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk factors for ground-level fall injuries during active activity in older patients 老年患者运动时地面坠落损伤的危险因素

4区医学

Signa Vitae Pub Date : 2023-01-01 DOI: 10.22514/sv.2023.099

{"title":"Risk factors for ground-level fall injuries during active activity in older patients","authors":"","doi":"10.22514/sv.2023.099","DOIUrl":"https://doi.org/10.22514/sv.2023.099","url":null,"abstract":"In older patients, ground-level falls are the most common cause of injury. Many intrinsic and extrinsic factors influence ground fall injuries. However, the characteristics and severity of ground fall injuries have not been compared according to the activity levels. We compared the characteristics of ground fall injuries by the activity level to establish a preventive strategy for ground fall injuries in older patients. We retrospectively reviewed the records of older patients who were admitted to six university hospitals for ground-level fall injuries from 2011 to 2020. The patients were classified into active and inactive groups. Active activities were defined as paid work, exercise and leisure activities. General and clinical characteristics of both groups for ground-level fall injury were analyzed. Propensity score matching analysis (1:1) was performed for baseline characteristics (sex, age and alcohol consumption). A total of 33,924 patients were enrolled, of which 4887 (14.4%) were classified in the active group. Injury severity was not different between the active and inactive groups. The main factors significantly associated with ground fall injuries during activities in elderly patients were male sex, age from 65 to 74 years and 75 to 84 years compared to greater than 85 years, an injury time other than 00:00–05:59, alcohol consumption, sloping floor and floor type other than concrete. After propensity score matching analysis, the factors associated with ground-level fall injuries in older patients when they were active were a time of injury from 06:00–17:59 compared to 00:00–05:59, slippery floor, slope, the absence of obstacles and type of floor other than concrete. We should establish preventive strategies for reducing ground-level fall injuries in older patients during activity, which could include wearing compatible footwear, caution on sloping areas, and maintenance of unpaved roads.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135156163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of combined laryngo-bronchoscopy intubation approach in a simulated difficult airway scenario with cervical stabilization 喉-支气管镜联合插管入路在模拟困难气道情况下颈椎稳定的应用

4区医学

Signa Vitae Pub Date : 2023-01-01 DOI: 10.22514/sv.2023.073

{"title":"Use of combined laryngo-bronchoscopy intubation approach in a simulated difficult airway scenario with cervical stabilization","authors":"","doi":"10.22514/sv.2023.073","DOIUrl":"https://doi.org/10.22514/sv.2023.073","url":null,"abstract":"The occurrence of unexpected difficult airway management (DAM) during endotracheal intubation (ETI) attempts represents a life-threatening scenario. The management of such challenges may improve with training in simulated DAM scenarios. Moreover, simulation allows investigation at the potential value of new devices and techniques for DAM. The combined use of laryngoscopy with fiberoptic bronchoscope (CLBI) has been proposed in this regard, but its performance by novices facing DAM remain unexplored. We performed a randomized crossover simulation study evaluating the performance of ninety-six anesthesiology residents during ETI with four approaches: direct laryngoscopy (DL), Glidescope®, McGrath® and CLBI. Increased difficulty was produced by placement of a cervical collar. Residents had maximum of 3 attempts per device/technique (up to 60 seconds per attempt). The main outcomes were success rate (SR) and corrected time-to-intubation (cTTI, with 60 seconds added for each failed attempt). Subgroup analyses were performed separating residents according to their experience (junior, n = 60; senior, n = 36).The CLBI had significantly lower SR at both 1st and 3rd attempt (31% and 64%, respectively) as compared to DL (93% and 98%), Glidescope® (70% and 86%) and McGrath® (58% and 84%), with all p < 0.001. Moreover, CLBI had significantly longer cTTI (158.5 seconds; (54.3; 180)) than other devices: Glidescope® (37.6 seconds; (24.7; 88.2)), McGrath® (39.3 seconds; (20.6; 105.1)), and DL (19 seconds; (15.4; 27.2)), all p < 0.002. CLBI and McGrath® were the only approaches performing better in senior as compared to junior residents. In a DAM simulated setting, anesthesiology residents had lower SR and longer cTTI with the CLBI as compared to direct and video-laryngoscopy.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135828100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anesthesia in patients with multiple chemical sensitivity: current understanding 对多种化学物质敏感患者的麻醉:目前的认识

4区医学

Signa Vitae Pub Date : 2023-01-01 DOI: 10.22514/sv.2023.096

{"title":"Anesthesia in patients with multiple chemical sensitivity: current understanding","authors":"","doi":"10.22514/sv.2023.096","DOIUrl":"https://doi.org/10.22514/sv.2023.096","url":null,"abstract":"Multiple Chemical Sensitivity (MCS) is a pathological condition that we do not yet have a clear understanding of from an etiological and clinical point of view. The underlying mechanisms of the disorder are still being investigated and the most frequently reported symptoms by patients are malaise, fatigue, headache, arthralgia, insomnia and dermatitis. Although this condition may entail a real risk of the occurrence of adverse reactions following exposure to many substances, often inhaled, or the taking of drugs, medical/scientific literature provides only a little information regarding the safest course of action to be taken when patients affected by MCS need to undergo anesthesia. It is for this reason that an electronic search of existing literature has been made, using PubMed and Scopus as a primary source, in order to find articles about patients affected by MCS and who have undergone anesthesia. The time frame considered was January 2000–December 2022. The research showed only 13 articles that dealt with anesthesia in patients with multiple chemical sensitivity in the years in question. Only 6 works, all case reports, describe the drugs used to perform anesthesia. Five cases were for general anesthesia and one was a case of subarachnoid block. No major complications related to anesthesiological practice were reported in any of the cases. The limited data does not enable the identification of anesthesiological practice and anesthetic drugs that can be used more safely in MCS patients, but the absence of serious adverse reactions in the case reports described, and in the literature in general, is reasonably reassuring about the possibility of anesthesia in MCS patients without causing serious complications by implementing easily achievable measures.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136202523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of diets containing synbiotics on the gut microbiota of critically ill septic patients: a pilot randomized controlled trial 含合生菌的饮食对重症脓毒症患者肠道微生物群的影响:一项随机对照试验

4区医学

Signa Vitae Pub Date : 2023-01-01 DOI: 10.22514/sv.2023.080

{"title":"Effects of diets containing synbiotics on the gut microbiota of critically ill septic patients: a pilot randomized controlled trial","authors":"","doi":"10.22514/sv.2023.080","DOIUrl":"https://doi.org/10.22514/sv.2023.080","url":null,"abstract":"The effects of synbiotics on gut microbiota have not been thoroughly clarified in critically ill patients with sepsis. In this present study, we aimed to evaluate the effects of synbiotics in a commercial diet on the gut microbiota of mechanically ventilated septic patients. This double-blind, randomized controlled clinical trial was conducted on septic patients under mechanical ventilation in a university-affiliated hospital in southern Thailand from February 2019 to March 2021. The patients were randomly divided into 2 groups stratified by sepsis stages and given commercial enteral feeding with synbiotics or standard commercial feeding for 7 days. The primary outcome was fecal microbial diversity measured as alpha and beta diversity. The secondary outcomes included ventilator-associated pneumonia, nosocomial diarrhea, ventilator days, length of hospital stay, and mortality. Twenty-four patients, 12 on a synbiotic diet and 12 on a non-synbiotic diet, completed this study. On day 3 of feeding, no significant difference was observed in their alpha fecal microbial diversity. However, significantly greater beta diversity was observed in the non-synbiotics group compared with the synbiotic group (Bray Curtis distance, p = 0.001; Jaccard’s distance, p = 0.001; unweighted UniFrac, p = 0.001; weighted UniFrac, p = 0.029). The secondary outcomes were not significantly different between the two groups. In critically ill septic patients, feeding with a commercial diet containing synbiotics did not significantly improve fecal microbial diversity. Due to the small sample size, further study is required.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"2013 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136298880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effect of early diuretics administration on acute kidney injury progression after cardiac surgery: a post-hoc analysis of a multicenter retrospective cohort study (BROTHER study) 早期使用利尿剂对心脏手术后急性肾损伤进展的影响:一项多中心回顾性队列研究(BROTHER研究)的事后分析

4区医学

Signa Vitae Pub Date : 2023-01-01 DOI: 10.22514/sv.2023.112

{"title":"The effect of early diuretics administration on acute kidney injury progression after cardiac surgery: a post-hoc analysis of a multicenter retrospective cohort study (BROTHER study)","authors":"","doi":"10.22514/sv.2023.112","DOIUrl":"https://doi.org/10.22514/sv.2023.112","url":null,"abstract":"Positive fluid balance is associated with acute kidney injury (AKI) following cardiac surgery in a dose-dependent manner. Although diuresis is a common intervention for fluid overload, the optimal timing of diuretic administration for preventing AKI after cardiac surgery remains unclear. We aimed to investigate whether early administration of diuretics after cardiac surgery is associated with subsequent AKI progression. This was a post-hoc analysis of a multicenter retrospective cohort study that included adult patients admitted to 14 intensive care units (ICUs) after elective cardiac surgery between January and December 2018. The exposure variable was the administration of intravenous diuretics during the initial 24 hours after ICU admission. The primary outcome was AKI progression, defined as one or more AKI stages using Kidney Disease: Improving Global Outcomes creatinine and urine output criteria between 24 and 72 hours compared with the worst stage during the first 24 hours. We used multivariable logistic regression analyses to assess the association between early administration of diuretics and AKI progression. Among the 718 patients analyzed, 335 (47%) received intravenous diuretics within the first 24 hours, and AKI progression occurred in 115 patients (16%). In the multivariable analyses, early diuresis was not associated with AKI progression (odds ratio, 1.12; 95% confidence interval, 0.74–1.69), confirmed by sensitivity analyses. Early administration of intravenous diuretics was not associated with a lower risk of AKI progression after cardiac surgery.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135559781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0