尿量监测有什么意义术中尿量监测很重要，与术后肾功能障碍密切相关-上海聚慕医疗器械有限公司

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摘要译文（供参考）

小儿心脏手术术中尿量与术后急性肾损伤关系的回顾性队列研究

背景：

已证实术中尿量(UO)可预测成人术后急性肾损伤(AKI)；然而，其在接受心脏手术的儿童中的意义仍不清楚。

目的：

目的探讨先天性心脏病患儿术中UO与术后AKI的关系。

设计：一项回顾性观察性研究。

实施：一家三级医院。

患者：2022年4月1日至2022年8月30日在阜外医院接受心脏手术的年龄>28天且<6岁的儿童。

主要结果指标：采用肾脏疾病改善总体结局(KDIGO)标准，通过术后7天内最高血清肌酐值确定AKI。

结果：

共纳入1184例儿童，AKI发生率为23.1%(273/1184)，其中1期占17.7%(209/1184)，2期占4.2%(50/1184)，3期占1.2%(14/1184)。

术中UO的计算方法是将术中总尿量除以手术持续时间和术前测量的实际体重。

AKI组和非AKI组的术中UO中位数[范围]无显著差异(分别为2.6[1.4至5.4]和2.7[1.4至4.9]，P=0.791)，且多因素logistic回归分析显示，术中UO与术后AKI无关[校正比值比(OR)0.971; 95% CI: 0.930 ～ 1.014; P = 0.182]。

关于AKI严重程度的临床重要性，我们进一步探讨了术中UO和术后中重度AKI之间的相关性(校正OR0.914；95%CI，0.838-0.998；P=0.046)。

结论：

在儿科心脏手术中，术中UO与术后AKI无关。然而，我们发现UO与术后中重度AKI之间存在显著相关性。这表明术中尿量低于特定阈值可能与术后肾功能不全有关。

试验注册：ClinicalTrials.gov

标识符：NCT05489263.

原文摘要

Relationship between intra-operative urine output and postoperative acute kidney injury in paediatric cardiac surgery: A retrospective cohort study

Background: Intra-operative urine output (UO) has been shown to predict postoperative acute kidney injury (AKI) in adults; however, its significance in children undergoing cardiac surgery remains unknown.

Objective: To explore the association between intra-operative UO and postoperative AKI in children with congenital heart disease.

Design: A retrospective observational study.

Setting: A tertiary hospital.

Patients: Children aged >28 days and <6 years who underwent cardiac surgery at Fuwai Hospital from 1 April 2022 to 30 August 2022.

Main outcome measures: AKI was identified by the highest serum creatinine value within postoperative 7 days using Kidney Disease Improving Global Outcomes (KDIGO) criteria.

Results: In total, 1184 children were included. The incidence of AKI was 23.1% (273/1184), of which 17.7% (209/1184) were stage 1, 4.2% (50/1184) were stage 2, and others were stage 3 (1.2%, 14/1184). Intra-operative UO was calculated by dividing the total intra-operative urine volume by the duration of surgery and the actual body weight measured before surgery. There was no significant difference in median [range] intra-operative UO between the AKI and non-AKI groups (2.6 [1.4 to 5.4] and 2.7 [1.4 to 4.9], respectively, P = 0.791), and multivariate logistic regression analyses showed that intra-operative UO was not associated with postoperative AKI [adjusted odds ratio (OR) 0.971; 95% confidence interval (CI), 0.930 to 1.014; P = 0.182]. Regarding the clinical importance of severe forms of AKI, we further explored the association between intra-operative UO and postoperative moderate-to-severe AKI (adjusted OR 0.914; 95% CI, 0.838 to 0.998; P = 0.046).

Conclusions: Intra-operative UO was not associated with postoperative AKI during paediatric cardiac surgery. However, we found a significant association between UO and postoperative moderate-to-severe AKI. This suggests that reductions in intra-operative urine output below a specific threshold may be associated with postoperative renal dysfunction.

Trial registration: Clinicaltrials.gov identifier: NCT05489263.

原文链接

Bie D, Li Y, Wang H, Liu Q, Dou D, Jia Y, Yuan S, Li Q, Wang J, Yan F. Relationship between intra-operative urine output and postoperative acute kidney injury in paediatric cardiac surgery: A retrospective cohort study. Eur J Anaesthesiol. 2024 Jul 18. doi: 10.1097/EJA.0000000000002044. Epub ahead of print. PMID: 39021216.