危急病患者和体外膜氧化支持中沃里康纳的药理动力学:一个回顾性比较病例对照研究
Mar Ronda1, Josep Manuel Llop-Talaveron2,3, MariPaz Fuset4
1Infectious Disease Department, Hospital Universitari de Bellvitge-IDIBELL, Hospitalet de Llobregat, 08907 Barcelona, Spain.
Antibiotics (Basel, Switzerland)
|July 29, 2023
概括
身体外膜氧化 (ECMO) 支持在重症患者中显著降低了沃里科纳的药物水平. 治疗药物监测和剂量调整对于在ECMO期间达到有效的抗真菌度至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
背景情况:
- 沃里康纳是一种关键的抗真菌药物,具有显著的药理动力学变异性.
- 达到1-5.5 mg/L的目标最低血度 (Cmin) 对于沃里可纳的疗效至关重要.
- 在接受体外膜氧化 (ECMO) 的患者中,真菌感染很常见,但在ECMO期间沃里科纳的药理动力学知之甚少.
研究的目的:
- 为了比较ECMO支持和没有ECMO支持的危急病患者中沃里康纳的药理动力学.
- 在接受ECMO的患者中确定影响伏利可纳Cmin的因素.
主要方法:
- 追溯队列研究,比较非ECMO和ECMO组中的沃里康纳Cmin.
- 分析了15名非ECMO患者的26次Cmin测定和9名ECMO患者的27次Cmin测定.
- 多变量分析以确定低Cmin.的风险因素.
主要成果:
- 与非ECMO组 (3.62 ± 3.88 mg/L) 相比,ECMO组显示出明显较低的伏利康纳Cmin (0.38 ± 2.98 mg/L).
- 在ECMO组中观察到较高比例的低治疗性Cmin值 (16对1).
- 确定ECMO支持和较低的血白蛋白水平是次疗法沃里可纳Cmin的独立风险因素.
结论:
- 欧共体的支持与显著减少的伏利可纳Cmin.相关.
- 治疗药物监测和剂量优化对于ECMO患者的沃里科纳治疗至关重要.
- 在ECMO患者中,可能需要更高的伏利康纳剂量 (6.44 mg/kg两次) 来达到治疗Cmin.
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