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Ming G Chai1,2, Rekha P Mangalore3,4, Joshua F Ihle2,5
1Pharmacy Department, Alfred Health, Melbourne, Victoria, Australia.
身体外膜氧化 (ECMO) 在重症患者中显著降低了波萨可纳水平,增加了亚治疗性抗真菌度的风险. 治疗药物监测至关重要,特别是在ECMO启动和脱管过程中.
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:
- 可纳对于预防和治疗重症患者的侵入性真菌感染至关重要.
- 身体外膜氧化 (ECMO) 电路可能会隔离波萨可纳,从而可能降低其疗效.
- 了解ECMO对波萨可纳水平的影响对于患者管理至关重要.
研究的目的:
- 评估ECMO对重症患者中波萨可纳度的影响.
- 为了比较ECMO和非ECMO患者之间的波萨可纳水平和目标达到.
- 为了评估 ECMO 启动和断管过程中波萨可纳度的变化.
主要方法:
- 重症患者接受静脉注射波萨可纳的回顾性队列研究.
- 在ECMO和非ECMO组之间比较波萨可纳度和达到目标水平 (>0.7 mg/L用于预防,>1 mg/L用于治疗).
- 分析与ECMO启动和脱相关的波萨可纳度变化.
主要成果:
- 与非ECMO患者相比,ECMO患者表现出明显较低的波萨可纳度 (0.7 mg/L vs 1.2 mg/L).
- 在ECMO患者中,较少的比例达到治疗性波萨可纳度 (13%对64%).
- ECMO启动与波萨康纳水平的降低有关,而脱与水平的增加有关.
结论:
- 在ECMO治疗的重症患者有较高的潜治疗性波萨可纳度的风险,可能会危及IFI治疗.
- 经过ECMO脱,可导致波萨可纳的度增加.
- 在ECMO患者中,对波萨可纳的密集治疗药物监测是必不可少的,特别是在ECMO启动和脱管周围.
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