抗真菌药物在患有体外膜氧化的患者:临床影响
Lisa Kriegl1,2, Stefan Hatzl2,3, Gernot Schilcher4
1Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Open forum infectious diseases
|June 18, 2024
概括
本综述探讨了用于体外膜氧化 (ECMO) 的患者的抗真菌治疗方法. 它建议最佳使用阿佐尔和埃奇诺坎丁,同时突出显示了对脂质体安二B的数据缺口.
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:
- 身体外膜氧化 (ECMO) 支持患有严重心肺衰竭的患者.
- 在ECMO患者中,真菌感染构成重大风险.
- 优化抗真菌治疗对于患者的治疗结果至关重要.
研究的目的:
- 审查并建议ECMO患者的抗真菌治疗和预防策略.
- 评估各种抗真菌剂的现有数据.
- 确定ECMO电路中药物度的研究缺口.
主要方法:
- 对ECMO中抗真菌使用的现有文献进行系统审查.
- 对阿佐尔,赤甘丁和安福特里辛B配方的数据分析.
- 评估ECMO电路内的药物度变化.
主要成果:
- 伊萨夫康纳和波萨康纳显示出最支持的数据,建议修改伊萨夫康纳的剂量.
- 埃奇诺坎丁在侵袭性白病中是首选的,但ECMO电路数据有限.
- 由于度的不确定性和潜在的ECMO电路效应,使用脂质体安二乙需要谨慎.
结论:
- 根据目前的数据,可以为ECMO患者提出特定的抗真菌方案.
- 关于ECMO电路中药物度的有限数据需要谨慎使用某些抗真菌药物.
- 进一步的研究是必要的,以了解ECMO对抗真菌药理学的影响,并优化剂量.
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