儿科患者的药物使用模式和剂量指导得到间歇性血液透析或连续脏替代疗法的支持
Autumn M McKnite1, Danielle J Green2, Raoul Nelson3
1Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT, USA. autumn.mcknite@neuro.utah.edu.
Pediatric nephrology (Berlin, Germany)
|December 5, 2023
概括
儿童血液透析患者往往缺乏特定药物剂量指导. 这项研究确定了在连续 (CKRT) 和间歇 (iHD) 置换疗法中常用的药物,没有明确的剂量建议,优先考虑未来的研究.
科学领域:
- 儿科病学 儿科病学
- 临床药理学 临床药理学
- 药理动力学 药理动力学
背景情况:
- 血液透析对于儿科功能衰竭至关重要,但会改变药物的药理动力学,冒着低于最佳剂量和毒性的风险.
- 对于儿科血液透析患者的现有剂量指南很少,通常汇集连续 (CKRT) 和间歇 (iHD) 治疗数据.
- 优先考虑研究药物对于在这些脆弱人群中制定基于证据的剂量指南至关重要.
研究的目的:
- 为接受CKRT和iHD的儿科患者确定优先使用的药物.
- 分析药物给药模式,并识别在这些特定的血液透析模式内缺乏公布剂量指南的药物.
主要方法:
- 利用机器学习模型识别接受CKRT或iHD的住院儿科患者.
- 在确定的患者队列中分析了药物管理模式.
- 确定了最常被处方的药物,每个模式都缺乏具体的剂量指导.
主要成果:
- 在iHD和CKRT之间观察到药物使用模式和剂量指导的显著差异.
- 抗生素,利尿剂和镇静剂在CKRT患者中更为普遍.
- 只有34%的常用药物在iHD和28%的CKRT中提供了剂量指导.
结论:
- 这项研究突出了小儿血液透析药物剂量指南中的关键差距.
- 它确定了需要在iHD和CKRT环境中进一步调查的关键药物.
- 为未来的研究提供了一个框架,以建立基于证据的小儿置换疗法的剂量策略.
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