危急病患者的抗真菌剂量在体外膜氧化时
Haifa Lyster1,2, Kiran Shekar3,4,5,6, Kevin Watt7,8
1Royal Brompton and Harefield Hospitals, Part of Guy's and St Thomas' NHS Foundation Trust, London, UK.
Clinical pharmacokinetics
|June 10, 2023
概括
外体膜氧化 (ECMO) 需要谨慎的抗真菌剂量由于改变的药理动力学. 建议在ECMO治疗的重症患者进行治疗药物监测,以确保有效的抗真菌暴露.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 传染性疾病 传染性疾病
背景情况:
- 身体外膜氧化 (ECMO) 为重症患者提供生命支持.
- ECMO患者的真菌感染与较高的死亡率有关.
- 抗真菌药物剂量在严重疾病中是复杂的,因为药物动力学 (PK) 发生了变化.
研究的目的:
- 对接受ECMO的重症患者的抗真菌药物剂量的现有文献进行审查.
- 提供关于在这个具有挑战性的患者群体中管理抗真菌治疗的指导.
主要方法:
- 在ECMO治疗的重症患者中对抗真菌药物的药理动力学 (PK) 研究的文献综述.
- 分析现有的案例报告和小样本研究.
主要成果:
- 目前关于ECMO患者抗真菌PK的文献有限,有不一致的发现和数据缺口.
- 药物动力学变化,包括分布量 (Vd) 和清除,由ECMO加剧.
- 现有的数据不足以为最终的经验剂量准则提供准则.
结论:
- 从非ECMO重症患者的剂量策略来看,这可能是一个合理的起点.
- 治疗药物监测对于优化抗真菌治疗和预防ECMO患者因高PK变异性而导致的毒性至关重要.
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