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在体外膜氧化中对抗微生物药物动力学的考虑
Kevin Johns1, Gregory Eschenauer1,2, Angela Clark1
1Department of Pharmacy Services, University of Michigan Health, Ann Arbor, MI 48109, USA.
Journal of clinical medicine
|June 27, 2024
概括
在体外膜氧化 (ECMO) 的重症患者中优化抗菌剂量是具有挑战性的,因为改变了药理动力学. 在这些复杂的病例中,治疗药物监测对于有效治疗和避免毒性至关重要.
科学领域:
- 药理学 药理学是指药理学的学科.
- 关键护理医学 关键护理医学
- 药物新陈代谢 药物新陈代谢
背景情况:
- 危急疾病会改变药物药理动力学 (PKs),使药物管理复杂化.
- 机械支持,如体外膜氧化 (ECMO) 可以通过封存和改变分布进一步影响药物PKs.
- 关于在ECMO治疗重症患者中的抗菌剂剂量的现有文献是有限的,难以解释.
研究的目的:
- 审查ECMO的重症患者抗微生物选择和剂量方面的挑战.
- 突出ECMO对药物药理动学的影响.
- 强调治疗药物监测在这一群体中的重要性.
主要方法:
- 文献综述侧重于重症患者的药物药理动力学.
- 分析影响ECMO电路内的药物行为因素.
- 对ECMO患者的抗微生物治疗中的挑战评估.
主要成果:
- 严重疾病和ECMO电路组件中的生理变化显著改变了药物的药理动力学.
- 脂性和高度与蛋白质结合的药物更容易在ECMO电路中被封存.
- 患者的变化和ECMO在降低药物度中的作用存在重大挑战.
结论:
- 在ECMO患者中,抗菌剂的选择和剂量需要仔细考虑药物特性,如脂性和蛋白质结合.
- 在这种人群中识别感染和评估治疗疗效是复杂的.
- 治疗药物监测对于优化抗微生物治疗和管理ECMO重症患者的毒性至关重要.
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