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Optimization of central venous pressure during the perioperative period is associated with improved prognosis of high-risk operation patients

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Journal of Intensive Medicine 2023年第2期3卷 165-170页

作者： Jiafang Wu Jun Li Han Chen Xiuling Shang Rongguo Yu The Third Department of Critical Care Medicine Shengli Clinical Medical College of Fujian Medical UniversityFujian Provincial HospitalFujian Provincial Center for Critical Care MedicineFujian Provincial Key Laboratory of Critical Care MedicineFuzhouFujian 350001China

Background:While central venous pressure(CVP)measurement is used to guide fluid management for high-risk surgical patients during the perioperative period,its relationship to patient prognosis is ***:This single-center,retrospective observational study enrolled patients undergoing high-risk surgery from February 1,2014 to November 31,2020,who were admitted to the surgical intensive care unit(ICU)directly after *** were divided into the following three groups according to the first CVP measurement(CVP1)after admission to the ICU:low,CVP112 *** fluid balance,28-day mortality,length of stay in the ICU,and hospitalization and surgical complications were compared across ***:Of the 775 high-risk surgical patients enrolled in the study,228 were included in the ***(interquartile range)positive fluid balance during surgery was lowest in the low CVP1 group and highest in the high CVP1 group(low CVP1:770[410,1205]mL;moderate CVP1:1070[685,1500]mL;high CVP1:1570[1008,2000]mL;all Pacute kidney injury(AKI)was lowest in the moderate CVP1 group(low CVP1:9.2%;moderate CVP1:2.7%;high CVP1:16.0%;P=0.007).The proportion of patients receiving renal replacement therapy was highest in the high CVP1 group(low CVP1:1.5%;moderate CVP1:0.9%;high CVP1:10.0%;P=0.014).Logistic regression analysis showed that intraoperative hypotension and CVP1>12 mmHg were risk factors for AKI within 72 h after surgery(adjusted odds ratio[aOR]=3.875,95%confidence inter

关键词： Perioperative Central venous pressure Fluid management acute renal injury

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Effects of Fufang Shenhua Tablet(复方肾华片) on the Expression of Toll-Like Receptors during acute Kidney injury Induced by Ischemia-Reperfusion in Rats

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Chinese Journal of Integrative Medicine 2012年第12期18卷 918-924页

作者：郑晓勇魏日胞师锁柱尹忠陈香美 Nephropathy of Chinese PLA General Hospital State Discipline and Key Laboratory of Kidney Disease(Chinese PLA General Hospital 2011DAV00088)

Objective： To investigate the impact of a traditional Chinese medicinal compound known as Fufang Shenhua Tablet （复方肾华片, SHP） on the expression of Toll-like receptors （TLRs） during renal ischemia-reperfusion injury （IRI）-induced acute kidney injury （AKI） in rats. Methods： A total of 28 Wistar rats were randomly divided into five groups：（1） pseudo-operation control group, （2） ischemia-reperfusion model group, （3） Astragaloside group, （4） high-dose SHP group, and （5） low-dose SHP group. There were four rats in the pseudo-operation group and six rats in each of the other groups. The accepted ischemia-reperfusion model was established after a 7-day gavage intervention, and pathological changes and renal function were observed, using an enzyme-linked immunosorbent assay （ELISA） to detect interleukin 8 （IL-8） and interferon gamma （IFN-r） levels, as well as immunohistochemical staining to detect altered levels of TLR2 and TLR4 expression in renal tissue. Results： After 24 h, renal pathological damage and the expression levels of serum creatinine （Scr）, IL-8, IFN- r, TLR2, and TLR4 were significantly higher in the model group as compared with the pseudo-operation group （P〈0.05）. In addition, at 24 h the above indicators decreased significantly in the Astragaloside group, high- dose SHP group and low-dose SHP group as compared with the ischemia-reperfusion model group （P〈0.05）. TLR2 and TLR4 expression levels were significantly reduced in the SHP treatment and Astragaloside group as compared with the pseudo-operation group （P〈0.05）. Further, the high-dose SHP group showed significantly less renal damage score and decreased levels of TLR expression than those of low-dose SHP group and Astragaloside group （all P〈0.05）. Conclusion： SHP can alleviate the renal structural and functional damage caused by IRI-induced AKI in rats by reducing the damage of renal pathology, which may reduce inflammatory cytokine levels by downregulating the expression of TLRs in renal tissue in a dose

关键词： acute renal injury ischemia-reperfusion rats Fufang Shenhua Tablet Toll-like receptor

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Prognosis of acute renal Failure of the Child during Severe Malaria in Niamey-Niger

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Open Journal of Nephrology 2018年第1期8卷 10-17页

作者： Zeinabou Maiga Moussa Tondi Moumouni Garba Guillaume Mahamat Abderraman Hassane Diongole Moussa Ibrahim Hamat Elmoctar Seydou Toure Ide Abdou Illiassou Soumeila Toure Aboubacar Illiassou Salamatou Niourou Service de Nephrologie Hemodialyse Faculte des sciences de la sante Universite Abdou Moumouni NigerNiameyNiger Service de Pediatrie Hopital National de NiameyNiameyNiger Service de Nephrologie Hemodialyse Hopital de la Renaissance de N’DjamenaN’DjamenaTchad Service de Nephrologie Hopital National de ZinderZinderNiger

Introduction: In malaria-endemic areas, acute renal failure (ARF) is one of the most serious complications, it occurs in 40% of severe forms of malaria in adults and is linked to 75% of deaths, especially when extra-renal cleaning is not available. In children, studies of ARF during malaria are limited. We have no published studies on this topic in Niger. The main objective of our study is to evaluate the prognosis of ARF during severe malaria in children. Patients and Method: This is a one-year prospective study (January 1, 2016 to December 31, 2016) conducted in the resuscitation unit of the pediatric department of the National Lamordé Hospital of Niamey (Niger). We included in the study children aged 0 to 15 years hospitalized for severe malaria with impaired renal function. Patients who had chronic renal failure or who had acute renal failure with a thick negative drop were excluded from the study. acute renal failure is defined according to Kidney Disease Improving Global Outcomes (KDIGO) criteria basing on creatinine clearance. Results: The incidence of ARF was 12.60%. The mean age of the patients was 4.25 ± 1.3 years [8 months - 15 years]. The mean hemoglobin level was 8.2 ± 2.7 g/dl. In 54.02% of cases, the hemoglobin level is ≤5 g/dl. Mean serum creatinine was 543.7 ± 69.5 μmol/l [107 - 2500 μmol/l] and mean azotemia was 27.5 ± 3.5 mmol/l. Severe anemia (54.02%) were more related to the occurrence of ARF(with p = 0.014). According to the RIFLE classification, 55 patients (63.22%) were in the Risk stage, 18 patients (20.69%) were in the injury stage and 14 patients (16.09%) in the failure stage. All patients were placed on injectable Artesunate. The average length of hospital stay was 8.6 ± 4.5 days [5 to 22 days]. Dialysis was reported in 15/87 (17.24%). For technical and financial reasons only 8 patients were hemodialysed. Indications for dialysis were severe uremic syndrome 7 cases (8.04%), fluid overload 5 cases (5.75%) and severe hyperkalemia 3 cases (3

关键词： acute renal injury Malaria Niger

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