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通过ex vivo体外生命支持电路提取美罗
Christopher Cole Honeycutt1, Charles Griffin McDaniel1, Autumn McKnite2
1Duke University, Durham, North Carolina, USA.
The journal of extra-corporeal technology
|December 15, 2023
概括
在连续脏替代疗法 (CRRT) 期间,美罗素被迅速清除,并最小吸附到体外膜氧化 (ECMO) 电路中. 这些发现为在需要生命支持的危急病患者中使用美罗胺剂量提供了信息.
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:
- 梅罗是治疗危急病患者的扩展谱β-乳糖酶 (ESBL) 生产肠杆菌菌引起的感染的重要抗生素.
- 许多重症患者需要体外膜氧化 (ECMO) 和/或连续置换疗法 (CRRT),因此需要了解这些循环中的药物药理动力学.
- 物理化学性质表明,ECMO的美罗胺提取量很小,CRRT的清除速度很快.
研究的目的:
- 在ex vivo ECMO和CRRT电路中确定美罗胺提取.
- 阐明不同ECMO电路组件对美罗胺提取的贡献.
- 提供数据,以优化在体外生命支持的患者中服用美罗的剂量.
主要方法:
- 在ex vivo ECMO (n=3) 和CRRT (n=4) 电路中使用标准的美罗胺剂量.
- 24小时 (ECMO) 和4小时 (CRRT) 连续取血样.
- 使用对照组来计算药物降解;量化美罗胺度,并计算百分比恢复.
主要成果:
- 在ECMO电路中,美罗的清除与对照组相似,在各种配置中恢复率有所不同 (完全:15.6%,氧化器:37.9%,:47.1%).
- 与对照组相比,CRRT电路显示梅罗胺清除速度较快 (2.36%在2小时内恢复,对照组93.0%).
- 观察到ECMO成分的美罗胺吸附率最小,但发生了显著的降解/代谢.
结论:
- 在CRRT血液过过程中,美洛经历了快速清除.
- ECMO电路显示了极小的美罗胺吸附,但在生理条件下发生了显著的降解/代谢.
- 这些体外发现对于指导ECMO和CRRT重症患者的美罗胺剂量策略至关重要.
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