医学
复苏
感染性休克
血液透析
败血症
终末期肾病
插管
透析
肾脏替代疗法
重症监护室
休克(循环)
重症监护医学
急诊医学
麻醉
外科
内科学
作者
Kartikeya Rajdev,Lazer Leifer,Gurkirat Sandhu,Benjamin Mann,Sami Pervaiz,Saad Habib,Abdul Hasan Siddiqui,Bino Joseph,Seleshi Demissie,Suzanne El‐Sayegh
标识
DOI:10.1016/j.jcrc.2019.10.008
摘要
Due to the potential risk of volume overload, physicians are hesitant to aggressively fluid-resuscitate septic patients with end-stage renal disease (ESRD) on hemodialysis (HD). Primary objective: To calculate the percentage of ESRD patients on HD (Case) who received ≥30 mL/Kg fluid resuscitation within the first 6 h compared to non-ESRD patients (Control) that presented with severe sepsis (SeS) or septic shock (SS). Secondary objectives: Effect of fluid resuscitation on intubation rate, need for urgent dialysis, hospital length of stay (LOS), intensive care unit (ICU) admission and LOS, need for vasopressors, and hospital mortality. Medical records of 715 patients with sepsis, SeS, SS, and ESRD were reviewed. We identified 104 Case and 111 Control patients. In the Case group, 23% of patients received ≥30 mL/Kg fluids compared to 60% in the Control group (p < 0.001). There was no significant difference in in-hospital mortality, need for urgent dialysis, intubation rates, ICU LOS, or hospital LOS between the two groups. Subgroup analysis between ESRD patients who received ≥30 mL/Kg (N = 80) vs those who received <30 mL/Kg (N = 24) showed no significant difference in any of the secondary outcomes. Compliance with 30 mL/Kg fluids was low for all patients but significantly lower for ESRD patients. Aggressive fluid resuscitation appears to be safe in ESRD patients.
科研通智能强力驱动
Strongly Powered by AbleSci AI