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Related Experiment Videos

Serum gentamicin concentrations during intratracheal administration.

F Vogel, M Exner, H von Lilienfeld-Toal

    Klinische Wochenschrift
    |May 2, 1984
    PubMed
    Summary

    Intratracheal aminoglycoside administration in mechanically ventilated patients can lead to significant serum concentrations, especially in those with renal impairment. Monitor levels closely to avoid toxicity and unnecessary systemic therapy.

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    Area of Science:

    • Pharmacology
    • Critical Care Medicine
    • Nephrology

    Background:

    • Intratracheal aminoglycoside administration is a prophylactic measure against bronchopulmonary infections in mechanically ventilated patients.
    • The impact of renal function on serum gentamicin concentrations following endotracheal administration requires further investigation.

    Purpose of the Study:

    • To measure serum gentamicin concentrations in mechanically ventilated patients with multiple organ failure.
    • To assess the influence of renal function on these concentrations after intratracheal administration.

    Main Methods:

    • A standard 40 mg gentamicin ampule was administered intratracheally every 6 hours.
    • Serum gentamicin concentrations were measured in patients with and without renal failure.

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    Main Results:

    • Patients without renal failure rarely exceeded 1.5 micrograms/ml.
    • Patients with renal failure showed average concentrations of 2-3.5 micrograms/ml, with some reaching up to 10.5 micrograms/ml.
    • Serum levels peaked 1 hour post-administration and returned to baseline within 6 hours.

    Conclusions:

    • Intratracheal aminoglycoside administration in patients with renal impairment can result in potentially toxic serum levels.
    • Concurrent systemic aminoglycoside therapy should be avoided in these patients to prevent adverse events.