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时间:2018-10-11
《【持续性肾脏替代治疗crrt英文精品课件】pediatric acute renal failure crrtdialysis outcome studies》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、PediatricAcuteRenalFailure:CRRT/DialysisOutcomeStudiesStuartL.Goldstein,MDAssistantProfessorofPediatricsBaylorCollegeofMedicinePediatricAcuteRenalFailure:IdealStudyDesignProspectiveprotocoldrivenentrycriteriatoensurethatpatientsandtheirrespectivedisea
2、sereceivesimilartreatmentControlforseverityofillness,primaryandco-morbiddiseasesAdequatepowertodetecteffectofaninterventiononoranassociationofaclinicalvariablewithoutcomePediatricAcuteRenalFailure:IdealStudyDesignProspectiveprotocoldrivenentrycriteriat
3、oensurethatpatientsandtheirrespectivediseasereceivesimilartreatment---Donotexist!Controlforseverityofillness,primaryandco-morbiddiseases---SomeinformationAdequatepowertodetecteffectofaninterventiononoranassociationofaclinicalvariablewithoutcome---Donote
4、xist!RenalReplacementTherapyinthePICU:PediatricOutcomeLiteratureFewpediatricstudies(allsinglecenter)useaseverityofillnessmeasuretoevaluateoutcomesinpCRRT:Lanenotedthatmortalitywasgreaterafterbonemarrowtransplantwhohad>10%fluidoverloadatthetimeofHDiniti
5、ationSmoyer2foundhighermortalityinpatientsonpressors.Faragson3foundPRISMtobeapooroutcomepredictorinpatientstreatedwithHDZobel4demonstratedthatchildrenwhoreceivedCRRTwithworseillnessseveritybyPRISMscorehadincreasedmortalityDidnotstratifybymodality1.BoneM
6、arrowTransplant13:613-7,19942.JASN6:1401-9,19953.PediatrNephrol7:703-7,19944.ChildNephrolUrol10:14-7,1990RenalReplacementTherapyinthePICUPediatricOutcomeLiterature122childrenstudiedNoPRISMscoresMostcommondiagnosisIHD:primaryrenalfailureCRRT:sepsis31%sur
7、vivalConclusion:patientswhoreceiveCRRTaremoreillMaxvoldNJetal:AmJKidneyDis1997Nov;30(5Suppl4):S84-8PediatricARF:IHDandCRRTBunchmanTEetal:PedNeph16:1067-1071,2001PediatricARF:DiseaseandSurvivalBunchmanTEetal:PedNeph16:1067-1071,2001PediatricARF:Modalitya
8、ndSurvival%SurvivalBunchmanTEetal:PedNeph16:1067-1071,2001P<0.01P<0.01PediatricARF:ModalityandSurvivalPatientsurvivalonpressors(35%)lowerthanwithoutpressors(89%)(p<0.01)LowersurvivalseeninCRRTthaninpatientswhoreceivedHDforalldise
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