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体外膜氧化 (ECMO) 对塞费皮姆血清度的影响

Christopher J Destache¹, Raul Isern², Dorothy Kenny²

¹School of Pharmacy & Health Professions, Creighton University, Omaha, NE 68178, USA.

Antibiotics (Basel, Switzerland)

|November 27, 2024

概括

这项研究发现,标准的塞费皮姆剂量 (每6小时1克) 在接受体外膜氧化 (ECMO) 治疗的重症患者中达到治疗性血清度. 需要进一步的研究来优化ECMO期间的抗生素剂量. 关键词:塞费皮姆,ECMO,抗生素剂量,药理动力学.

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
传染性疾病传染性疾病

背景情况:

身体外膜氧化 (ECMO) 是重症患者的重要生命支持.
有限的数据存在于beta-lactam抗生素的药理动力学和ECMO患者的剂量.
优化抗生素治疗对于改善这一群体的结果至关重要.

研究的目的:

在接受ECMO的患者中评估cefepime血清度.
为了确定ECMO电路对cefepime药理动学的影响.
为ECMO患者指导塞菲皮姆的治疗剂量策略.

主要方法:

该研究包括成年患者 (≥19岁) 接受ECMO治疗,需要β-乳糖抗生素.
在ECMO前和ECMO内收集了三个血清样本 (峰值,中点,低点).
使用非分区分析 (NCA) 分析了塞费皮姆度.

主要成果:

八名患者符合纳入标准;六名患者接受了塞费皮姆 (1克每6小时).
血清度-时间曲线下的面积 (AUC) 在ECMO期间 (329.6 ± 32.3 mg*h/L) 与ECMO前 (211.9 ± 29.6 mg*h/L) (p=0.023) 相比显著更高.
没有观察到神经毒性,标准剂量似乎达到治疗水平.

结论:

标准的cefepime剂量 (每6小时1克) 对于ECMO的危急病患者来说似乎足够.
ECMO可能会增加cefepime的暴露,这表明剂量调整的可能性.
需要进一步的药理动力学研究来完善ECMO期间抗生素的剂量协议.

关键词:

在ECMO中,可以使用ECMO.这是一个很快的时间.药物动力学药物动力学

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