在治疗危急病患者感染时,不达到美罗的度目标的预测因素
International journal of clinical pharmacology and therapeutics
|November 16, 2023
概括
增加脏清除 (ARC) 是达到重症患者度目标的关键因素. 肌素清除量的增加增加增加了次治疗水平的风险,需要仔细监测.
科学领域:
- 药理动力学和药理动力学
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
背景情况:
- 亚治疗性β-乳糖抗生素度在重症患者中很常见.
- 高剂量的美罗可能无法达到目标度.
- 识别未达到治疗的危险因素对于优化治疗至关重要.
研究的目的:
- 确定未能达到度目标的风险因素.
- 调查重症监护室 (ICU) 患者中亚治疗性美洛水平的预测因素.
- 在重症患者群体中为美罗的剂量策略提供信息.
主要方法:
- 对成年ICU患者通过静脉输液接受美洛的回顾性研究.
- 治疗药物监测 (TDM) 用于测量美罗烯的最低度 (Cmin).
- 血液样本的UPLC-MS分析;用于识别风险因素的后勤回归.
主要成果:
- 19.5%的患者 (41/210) 没有达到度的目标.
- 多变量分析确定了年龄,剂量和增强的干净度 (ARC) 作为未达到预测因素.
- 较高的肌素清除与低治疗性美罗胺水平的风险增加相关.
结论:
- 增加脏清除 (ARC) 是未达到美罗胺度目标的重要预测因子.
- 年龄和剂量也会导致次治疗水平的风险.
- 临床医生应考虑ARC和肌素清除剂量时,在重症患者服用美洛来确保有效性.
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