在ADVANCED器官支持血液透析过程中在体外消除抗菌药物
Christina König1,2, Otto Frey3, Susanne Himmelein4
1Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Frontiers in pharmacology
|December 31, 2024
概括
在连续脏替代疗法期间,ADVOS系统有效地从血液中去除抗微生物,包括蛋白质结合药物. 剂量调整和治疗药物监测对于接受ADVOS治疗的重症患者至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 急性损伤 (AKI) 在需要持续置换疗法 (CRRT) 的重症患者中很常见.
- 高级器官支持系统 (ADVOS) 是一种新型的CRRT机器,使用蛋白丰富透析剂去除毒素和药物.
- 关于ADVOS系统去除抗微生物的数据以前没有报告.
研究的目的:
- 通过ADVOS系统研究各种抗微生物的体外去除.
- 评估ADVOS治疗期间蛋白质结合和流速对抗微生物清除的影响.
主要方法:
- 一项采用猪血和持续的抗菌素注射的体外研究.
- 对具有不同蛋白质结合,分子重量和清量的药物进行评估:安尼杜拉金,塞福塔克西姆,达普托米辛,可纳,甘西克洛维尔,线索利德,美罗和皮佩拉西林.
主要成果:
- 所有测试的抗微生物被ADVOS系统去除.
- 低蛋白结合药物的清除率在2.74至3.4升/小时之间,并随流量增加而增加.
- 高蛋白结合药物达普托米辛和阿尼杜拉金的清除率较低 (分别为1.36升/小时和0.84升/小时).
结论:
- 在ADVOS系统显著消除蛋白质结合和不结合的抗微生物.
- 使用ADVOS系统时,需要调整抗菌剂量.
- 需要进行临床研究来证实这些发现,并且建议在此期间进行治疗药物监测.
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