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
作者:
作者单位:

作者简介:

女,硕士在读,副主任护师

通讯作者:

基金项目:

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)


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

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
    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。

    Abstract:

    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.

    参考文献
    相似文献
    引证文献
引用本文

邢星敏,赵振华,周慧,冯波,缪雪怡,许勤.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[J].护理学杂志,2025,40(16):25-29

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
历史
  • 收稿日期:2025-03-04
  • 最后修改日期:2025-05-10
  • 录用日期:
  • 在线发布日期: 2025-09-26