重症患者连续性肾脏替代治疗早期体温变化轨迹及预测因素研究被引量：1

Early trajectory(0-8 h)of body temperature changes and predictors in critically ill patients initiating continuous renal replacement therapy

暂未订购

导出

摘要目的探讨重症患者连续性肾脏替代治疗早期体温变化轨迹及预测因素,为制订个体化体温管理方案提供依据。方法采用回顾性研究方法,纳入2022年1月至2024年10月ICU收治的263例连续性肾脏替代治疗重症患者,收集患者连续性肾脏替代治疗前1 h至治疗8 h的体温数据。通过潜类别增长混合模型识别体温动态轨迹类别;采用无序多分类logistic回归分析不同体温变化轨迹类别的预测因素。结果共识别出重症患者连续性肾脏替代治疗早期3类体温变化轨迹:体温恒定组(80.2%)、体温下降组(11.8%)和体温波动组(8.0%)。logistic回归分析结果显示,平均动脉压和基线体温是重症患者连续性肾脏替代治疗早期体温变化轨迹的独立预测因素(均P<0.05)。结论重症患者连续性肾脏替代治疗早期体温变化轨迹存在显著异质性,医护人员应根据基线平均动脉压及基线体温早期识别重症患者连续性肾脏替代治疗早期的体温变化趋势,实施分层管理策略,维持体温稳定。 Objective To investigate body temperature trajectories and identify predictors during the early phase(first 8 h)of continuous renal replacement therapy(CRRT)in critically ill patients,and to provide a foundation for developing personalized temperature management protocols.Methods A retrospective study was conducted involving 263 critically ill patients who received CRRT in the ICU between January 2022 and October 2024.Body temperature data were collected 1 hour before CRRT initiation and at intervals during the first 8 hours of therapy.Latent growth mixture modeling(LGMM)was used to identify distinct body temperature trajectories.Multinomial logistic regression was then employed to determine predictive factors for trajectories.Results Three trajectories were identified:stable(80.2%),progressive decline(11.8%),and fluctuating(8.0%).The mean arterial pressure(MAP)and baseline body temperature were predictors of the trajectory patterns(all P<0.05).Conclusion Body tempe-rature trajectories during the initial 8 hours of CRRT exhibit significant heterogeneity among critically ill patients.Healthcare providers can utilize patients′baseline MAP and body temperature to predict their likely thermal trajectory.This enables the implementation of tiered,proactive temperature management strategies aimed at maintaining thermal stability.

作者邢星敏赵振华周慧冯波缪雪怡许勤 Xing Xingmin;Zhao Zhenhua;Zhou Hui;Feng Bo;Miao Xueyi;Xu Qin(School of Nursing,Nanjing Medical University,Nanjing 211112,China)

机构地区南京医科大学护理学院南京鼓楼医院重症医学科温州医科大学附属眼视光医院护理部

出处《护理学杂志》北大核心 2025年第16期25-29,共5页 Journal of Nursing Science

基金国家卫生健康委医院管理所医疗质量(循证)管理研究项目(YLZLXZ23G008) 南京大学中国医院改革发展研究院课题(NDYGN2023015)。

关键词重症患者连续性肾脏替代治疗体温低体温变化轨迹潜在类别预测因素 critically ill patients continuous renal replacement therapy body temperature hypothermia development trajectory latent class predictive factors