在神经临界护理人群中增加清除的患病率和预测
Aaron M Cook1, David Li2, Melissa A Nestor1
1UK HealthCare Pharmacy Services and Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA.
增加干净度 (ARC) 在神经临界护理患者中很常见. 北极地区的得分比标准肌素估计更好地预测了ARC,有助于在这个人群中剂量药物.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临界护理医学 临界护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 增加清除 (ARC),定义为肌素清除 (CrCl) >130mL/min/1.73m2,在神经损伤的患者中很常见.
- 在神经临床护理环境中,ARC可以显著影响药物暴露和治疗疗效.
- 在这个特定的患者群体中,估计和测量CrCl之间的相关性存在有限的数据.
研究的目的:
- 在神经临界护理患者中调查增强清除 (ARC) 和估计的肌素清除 (CrCl) 之间的关联.
- 评估ARC与神经结果之间的关系.
- 为了比较ARCTIC得分和传统的CrCl方程在识别ARC的表现.
主要方法:
- 进行了一项单中心,前性,观察性队列研究.
- 包括因神经学原因而导致严重疾病的成年患者 (18-85岁),并且在入院时没有功能障碍.
- 分析了在住院第一周内至少有一次测量CrCl的患者,并比较了ARC和非ARC队列.
主要成果:
- 在57名患者中,有86% (49) 患有ARC,其中位数为201.7mL/min/1.73m2的CrCl,与非ARC组的109.8mL/min/1.73m2相比.
- 北极地区的得分与ARC发育的相关性比标准的CrCl估计方程更强 (AUC为0.648).
- 患有ARC的患者更有可能是男性.
结论:
- 在这种神经临床护理人群中,增加的干净度 (ARC) 非常普遍 (86%).
- 与基于血清肌素的估计相比,ARCTIC评分显示了诊断ARC的更高的灵敏度和特异性.
- 准确识别ARC对于优化神经临床护理中的药物治疗至关重要.
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