在重症患者中实现β-乳糖PK/PD目标的决定因素:单一中心回顾性研究
H Gandéga1, H Poujol2, M Mezzarobba3
1Department of Pharmacy, Nimes University Hospital, University of Montpellier, Nimes, France.
Journal of critical care
|May 17, 2024
概括
在ICU中达到目标Blad (BL) 血度是困难的. 诸如功能和体重等因素会影响达到的目标,而CRRT和美洛会增加过量服用的风险.
科学领域:
- 药理动力学和药理动力学
- 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) 中优化抗生素剂量对于患者的治疗结果至关重要.
- 治疗药物监测 (TDM) 的β-乳糖 (BL) 抗生素有助于指导剂量调整.
- 关于BL血度和影响目标达到的因素的现实数据有限.
研究的目的:
- 确定与在ICU患者中达到目标BL血度相关的因素.
- 描述BL抗生素的真实世界TDM数据.
- 为改善治疗疗效的剂量优化策略提供信息.
主要方法:
- 回顾性单中心研究,包括156名ICU患者,至少有一名BL TDM.
- 评估达到度目标的患者比例 (100%fT>4至8MIC).
- 单变量和多变量分析以确定BL目标实现的决定因素.
主要成果:
- 只有34%的患者在第一次服用时达到目标BL度;50%的患者过量服用,16%的患者过量服用.
- CKD-EPI估计的淋巴细胞过率和总体体重是实现目标的关键决定因素.
- 连续脏替代疗法 (CRRT) 和美罗使用是过量服用的危险因素.
结论:
- 在ICU环境中,达到目标BL血度仍然是一个重大挑战.
- 确定BL目标实现的预测因素对于快速剂量优化至关重要.
- 实施有针对性的策略可以减轻高风险患者低剂量和过量服用的风险.
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