在重症患者中评估自由氨酸度
Caitlin S Brown1, JiTong Liu2, Richard R Riker3,4
1Department of Pharmacy, Mayo Clinic, Rochester, MN.
Critical care explorations
|November 9, 2023
概括
在ICU患者中,总烯酸盐水平通常不反映自由烯酸盐度,70%显示不一致. 低albuminemia与较高的自由氨酸水平有关.
科学领域:
- 药理动力学 药理动力学
- 关键护理医学 关键护理医学
- 治疗药物监测 治疗药物监测
背景情况:
- 在重症监护室 (ICU) 患者中,氨酸与蛋白质的结合非常可变.
- 总烯酸盐度是自由烯酸盐度的不可靠预测指标,即使考虑到白蛋白水平.
- 准确评估自由氨酸对于有效的治疗药物监测在重症患者至关重要.
研究的目的:
- 在ICU患者中量化自由氨酸度.
- 为了确定与自由氨酸度升高相关的危险因素.
- 评估自由氨酸度与药物不良影响之间的关系.
主要方法:
- 追溯的多中心队列研究,涉及两个学术医学中心.
- 包括256名成年患者 (≥18岁) 与ICU同时进行自由和总氨酸测量.
- 分析了自由氨酸度,总氨酸,白蛋白水平和不良事件之间的关联.
主要成果:
- 在70%的患者中观察到自由和总酸盐度之间的治疗不一致.
- 较高的自由烯酸盐度与总烯酸盐度的增加和血清白蛋白的降低显著相关.
- 在这个队列中,没有发现自由氨酸度和不良反应之间的显著关联.
结论:
- 大多数ICU患者 (70%) 呈现出不一致的总和自由氨酸度.
- 低albuminemia和较高的总氨酸度是增加自由氨酸水平的危险因素.
- 在临床决策中仅仅依靠氨酸总度对许多ICU患者来说可能是不准确的,需要进一步研究.
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