心不全の重症患者におけるディゴキシン濃度の監視
Marek Grochla1,2,3, Marcin Basiak2, Ewa Sztohryn3
1Department of Anesthesiology and Intensive Therapy in Zabrze, Medical University of Silesia in Katowice, 40-055 Katowice, Poland.
Medicina (Kaunas, Lithuania)
|August 28, 2025
まとめ
常規の治療薬モニタリング (TDM) は,心臓機能不全の重症治療室 (ICU) の患者にとって有益です. TDMは投与量を最適化し,副作用を軽減することを示唆しています.
科学分野:
- 薬理学について
- クリティカル ケア 医療
- 心臓病科
背景:
- 自然由来の薬であるディゴキシン (Digoxin) は,今でも集中治療室 (ICU) で使用されています.
- ICUでの心不全の管理には,しばしばディゴキシンの投与が含まれます.
- 重症患者のディゴキシンの治療薬モニタリング (TDM) の役割は評価する必要があります.
研究 の 目的:
- 心不全と診断されたICU患者におけるディゴキシンの定期的な治療薬モニタリング (TDM) の有効性を評価する.
- ICU環境におけるディゴキシン濃度と患者のアウトカムに影響を与える要因を特定する.
主な方法:
- 2018年1月から2023年7月までのICUデータベースの記録を利用した単一のセンターでの遡及研究.
- 心不全のためにディゴキシンを受けているICU患者103人,適切なモニタリング.
- 排除基準: ディゴキシンの使用なし,ディゴキシンの単一のレベル測定,または心不全の診断がない.
主要な成果:
- 女性には男性より著しく低いディゴキシン用量 (0. 171 ± 0. 053 mg 対 0. 224 ± 0. 080 mg; p < 0. 001) が投与された.
- 血清ディゴキシン濃度は,生存者よりも生存者よりも高かった (1. 33 ± 0. 59 ng/ ml; p = 0. 003).
- 肝機能不全の患者は,肝機能不全の患者と比較して,より高いディゴキシン濃度 (1. 31 ± 0. 58 ng/ mL) を示した (1. 06 ± 0. 46 ng/ mL; p = 0. 016).
結論:
- 多臓器不全と肝機能障害のICU患者は,血清ディゴキシンの濃度が高い傾向にあります.
- ICU患者におけるディゴキシンの定期的なTDMは,投与量を最適化し,副作用を最小限に抑えるのに有益である.
- ディゴキシンの投与量は,性別,肝機能,重症院での患者の生存期間によって調整される場合があります.
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