背景:连续肾脏替代疗法(CKRT)可用于医院中一些最危重的患者。这种疗法是昂贵的并且需要多学科团队的协调以确保规定的剂量被递送。随着对重症监护护理人员的需求增加,重症监护病房患者的复杂性增加,我们评估了专门的肾脏技术专家在确保提供处方剂量方面的作用.因此,本研究的目的是调查在阿拉伯联合酋长国,支持重症监护病房护士与专业肾脏科医师合作对优化CKRT课程效率的影响.
方法:这是一项回顾性研究,比较了在专业肾脏技术专家监督下接受CKRT的危重病人与2021年未承保的危重病人。
结果:共纳入了158名患者的331个疗程。与未覆盖组相比,专业肾脏技术人员覆盖的患者的平均过滤器寿命更长(66vs.59小时,p=0.019)。在通过多元回归分析对风险因素进行调整后(即,年龄,性别,机械通气,脓毒症,平均动脉压,血管升压药,和SOFA)可能会影响CKRT机器的过滤器寿命,专门的肾脏技术专家的存在导致过滤器寿命显著延长(系数0.129;CI95%1.080,11.970;p值:0.019).
结论:我们的研究表明,专业的肾脏技术人员在延长CKRT机的过滤器寿命和优化CKRT机的效率方面发挥着至关重要的作用。进一步的研究应该集中在其他潜在的好处,有专门的肾脏技术人员进行CKRT会议,并确认这项研究的发现。此外,可以进行成本效益分析,以确定由专业团队执行CKRT的经济影响.
BACKGROUND: Continuous renal replacement therapy (CKRT) is delivered to some of the most critically ill patients in hospitals. This therapy is expensive and requires coordination of multidisciplinary teams to ensure the prescribed dose is delivered. With increased demands on the critical care nursing staff and increased complexities of patients admitted to critical care units, we evaluated the role of specialized renal technologists in ensuring the prescribed dose is delivered. Therefore, the aim of this
study is to investigate the impact of supporting intensive care unit nurses with specialized renal technologists on optimizing efficiency of CKRT sessions in the United Arab Emirates.
METHODS: This is a retrospective
study that compared critically ill patients on CKRT overseen by specialized renal technologists versus who are non-covered in the year 2021.
RESULTS: A total of 331 sessions on 158 patients were included in the
study. The mean filter life was longer in specialized renal technologists-covered patients compared to the non-covered group (66 vs. 59 h, p = 0.019). After adjustment by multiple regression analysis for risk factors (i.e., age, gender, mechanical ventilation, sepsis, mean arterial pressure, vasopressors, and SOFA) that may affect CKRT machines\' filter life, presence of a specialized renal technologists resulted in significantly longer filter life (co-efficient 0.129; CI 95% 1.080, 11.970; p-value: 0.019).
CONCLUSIONS: Our
study suggests that specialized renal technologists play a vital role in prolonging CKRT machine\'s filter life span and optimizing CKRT machine\'s efficiency. Further research should focus on other potential benefits of having specialized renal technologists performing CKRT sessions, and to confirm the finding of this
study. Additionally, a cost-benefit analysis could be conducted to determine the economic impact of having specialized teams performing CKRT.