[Analysis of influencing factors of trough serum vancomycin concentrations in critically ill neurosurgical patients].

万古霉素 医学 槽浓度 肌酐 治疗药物监测 血清浓度 重症监护室 加药 内科学 麻醉 药代动力学 金黄色葡萄球菌 遗传学 生物 细菌
作者
Min‐Xia Yao,Jingchao Li,Lei Shi,Yufang Wang,Sheng Wang,Xiangdong Guan,Bin Ouyang
出处
期刊:PubMed 卷期号:31 (11): 1384-1388 被引量:2
标识
DOI:10.3760/cma.j.issn.2095-4352.2019.11.014
摘要

To evaluate trough serum vancomycin concentrations and identify their influencing factors in critically ill neurosurgical patients.A retrospective study was conducted. Adult patients who received vancomycin with at least one appropriate monitoring of trough serum vancomycin concentration and admitted to neurosurgical intensive care unit (ICU) of the First Affiliated Hospital of Sun Yat-sen University from November 2017 to July 2019 were enrolled. General information including gender, age, comorbidities, etc., trough serum vancomycin concentrations, vancomycin dosage, duration of vancomycin therapy, urine output, serum creatinine (SCr), concurrent medications (including mannitol,diuretic, vasopressors, non-steroidal anti-inflammatory drugs, polymyxin, aminoglycosides and contrast medium, etc.) were collected for analysis. Trough serum vancomycin concentrations were evaluated and their influencing factors were analyzed by multiple linear regression method.In total, 81 trough serum vancomycin concentration data sets obtained from 28 patients were evaluated. (1) The initial daily dose of vancomycin was 2.00 (2.00, 2.00) g/d. After 4-6 doses, the trough serum vancomycin concentration obtained from initial blood draw was 10.99 (6.98, 16.25) mg/L, of which only 17.9% (5/28) achieving targeted concentrations (15-20 mg/L), 71.4% (20/28) subtherapeutic level and 10.7% (3/28) supratherapeutic level. (2) The duration of vancomycin therapy was 8.0 (6.0, 15.0) days. With average daily dose of 2.00 (1.75, 3.00) g/d, targeted trough vancomycin concentrations were achieved in only 30.9% (25/81) of all cases, subtherapeutic concentrations in 49.4% (40/81) and supratherapeutic concentrations in 19.7% (16/81). (3) There were significant differences in age, comorbidities, vancomycin dosage, diuretics use and mannitol dosage, etc. among different vancomycin concentration groups. Multiple linear regression analysis suggested that the trough serum vancomycin concentration increased by 0.14 mg/L [95% confidence interval (95%CI) was 0.06-0.22] for every 1 year increase in age, increased by 7.22 mg/L (95%CI was 2.08-12.36) in patients with multiple comorbidities (concomitant hypertension, diabetes and coronary heart disease) compared with those without comorbidities, increased by 2.78 mg/L (95%CI was 0.20-5.35) in patients treated with diuretics compared with those without diuretics. The effect of other variables was not statistically significant. It suggested that age, multiple comorbidities (concomitant hypertension, diabetes and coronary heart disease), and diuretic usage affected trough serum vancomycin concentrations.Targeted trough serum vancomycin level is not often achieved in neurosurgical ICU patients following standard dosing. Younger patients are associated with lower trough serum vancomycin concentrations, while diuretic usage, combined with multiple comorbidities are associated with higher trough serum vancomycin concentrations.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
小胡先森完成签到,获得积分20
1秒前
1秒前
1秒前
kuny完成签到,获得积分10
1秒前
BBIBBI完成签到,获得积分10
2秒前
2秒前
zain完成签到 ,获得积分10
3秒前
欧耶欧椰完成签到 ,获得积分10
3秒前
sun完成签到,获得积分10
3秒前
3秒前
糟糕的访梦完成签到,获得积分10
5秒前
5秒前
俊逸乐驹发布了新的文献求助10
5秒前
hahaha完成签到,获得积分10
5秒前
斯文败类应助科研通管家采纳,获得10
5秒前
我是老大应助科研通管家采纳,获得10
5秒前
科研通AI2S应助科研通管家采纳,获得10
5秒前
CodeCraft应助科研通管家采纳,获得10
5秒前
852应助科研通管家采纳,获得30
5秒前
共享精神应助科研通管家采纳,获得10
5秒前
小胡先森发布了新的文献求助10
5秒前
huang完成签到,获得积分20
6秒前
6秒前
6秒前
6秒前
徐上进发布了新的文献求助10
7秒前
8秒前
简单如容完成签到,获得积分10
9秒前
9秒前
9秒前
青云应助LLL采纳,获得10
10秒前
zhangsong1993发布了新的文献求助10
10秒前
11秒前
11秒前
peter关注了科研通微信公众号
12秒前
Owen应助djfnf采纳,获得10
13秒前
Curllen完成签到,获得积分10
13秒前
14秒前
甜蜜秋荷发布了新的文献求助10
14秒前
高分求助中
Lire en communiste 1000
Ore genesis in the Zambian Copperbelt with particular reference to the northern sector of the Chambishi basin 800
Becoming: An Introduction to Jung's Concept of Individuation 600
Communist propaganda: a fact book, 1957-1958 500
Briefe aus Shanghai 1946‒1952 (Dokumente eines Kulturschocks) 500
A new species of Coccus (Homoptera: Coccoidea) from Malawi 500
A new species of Velataspis (Hemiptera Coccoidea Diaspididae) from tea in Assam 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3167791
求助须知:如何正确求助?哪些是违规求助? 2819164
关于积分的说明 7925456
捐赠科研通 2479083
什么是DOI,文献DOI怎么找? 1320632
科研通“疑难数据库(出版商)”最低求助积分说明 632856
版权声明 602443