在ARDSCOVID-19患者的血小板缩风险在vvECMO治疗期间接受高剂量线索立德治疗:一项观察性研究
Pedja Kovacevic1,2, Dragana Milakovic3, Tijana Kovacevic3,4
1Medical Intensive Care Unit, University Clinical Centre of the Republic of Srpska, Dvanaest Beba Bb, 78000, Banja Luka, The Republic of Srpska, Bosnia and Herzegovina. pedja.kovacevic@med.unibl.org.
Naunyn-Schmiedeberg's archives of pharmacology
|May 7, 2024
概括
接受线化物 (LZD) 的体外膜氧化 (ECMO) 患者出现高血小板缺血率. 在ECMO治疗期间,监测血小板计数至关重要,以防止这种与线索立德相关的不良事件.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 需要体外膜氧化 (ECMO) 的患者容易患上医院感染,通常是由阳性病原体引起的.
- 利尼佐利德 (LZD) 是治疗这些感染的关键抗生素,但其在ECMO期间的剂量是复杂的,并与不良事件相关.
- 血小板缺血是重症患者的重大问题,特别是那些接受ECMO和接受LZD治疗的患者.
研究的目的:
- 评估在体外膜氧化 (ECMO) 期间用线索利德 (LZD) 治疗的患者中血小板缺血的发生率和特征.
- 确定该患者群体中线索利德最低度和血小板缺血的发生之间的关系.
主要方法:
- 一项前性观察性研究包括11名危急病患者,他们在ECMO期间接受肠道线索利 (600毫克每8小时) 治疗.
- 测量了莱涅佐利德的最低度,并将8mg/L作为评估血小板缺血风险的截止值.
- 在整个研究期间,对血小板数量进行了监测,并根据LZD最低度对患者进行分组.
主要成果:
- 81.8%的患者在ECMO. linezolid治疗期间发生了血栓塞缩症.
- 线化物中位数最低度为7.85 mg/L.
- 在多个时间点的LZD最低度较低 (<8 mg/L) 和较高 (≥8 mg/L) 的组之间观察到血小板平均值的显著差异,表明LZD水平和血小板减少之间存在相关性.
结论:
- 在接受ECMO的患者中,与林氏素相关的血小板缺血非常普遍.
- 在ECMO期间用linezolid治疗的患者中,无论剂量如何,血小板数量显著降低,需要谨慎监测.
- 密切监测血小板计数是必要的,以减轻在ECMO患者中因线索利德诱导的血小板缩的风险.
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