在重症监护室的目标控制输注:一个范围审查
Michele Introna1,2, Carla Carozzi3, Andrea Gentile3,4
1Neurointensive Care Unit, Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. michele.introna@istituto-besta.it.
目标控制输液 (TCI) 系统在重症监护室 (ICU) 提供精确的药物输送,改善镇静和止痛作用. 然而,需要更多的研究来验证它们与抗生素和先进的药理动力学模型的使用.
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
- 药理动力学/药理动力学
背景情况:
- 目标控制输注 (TCI) 系统使用药物动力学-药物动力学 (PKPD) 模型精确地输送药物,主要是在手术室.
- 它们在重症监护室 (ICU) 的使用是有限的,尽管严重病患者的复杂剂量需求.
研究的目的:
- 评估现有的关于在ICU环境中TCI系统应用的证据.
- 专注于镇静,止痛和抗生素的使用.
主要方法:
- 在Medline和Cochrane图书馆进行系统的文献搜索,截至2024年8月.
- 包括对接受任何药物的TCI的成年ICU患者的研究.
- 关于研究设计,PKPD模型,性能和临床终点的数据提取.
主要成果:
- 14项研究使用Marsh和Minto模型专注于镇静剂 (propofol,remifentanil),显示稳定的镇静和较少的不良事件.
- 对于德克斯梅德托米丁和米达佐拉姆的证据有限.
- 三项研究探讨了具有潜力但缺乏验证的抗生素TCI (万科米辛,塞费皮姆).
结论:
- 在ICU中,TCI对镇静和止痛有希望,改善药物定位和患者的治疗结果.
- 用抗生素和较新的PKPD模型进行TCI的证据不足.
- 更广泛的ICU应用需要进一步的临床研究和模型验证.
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