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首页> 外文期刊>Annals of Intensive Care >Vancomycin continuous infusion versus intermittent infusion during continuous venovenous hemofiltration: slow and steady may win the race
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Vancomycin continuous infusion versus intermittent infusion during continuous venovenous hemofiltration: slow and steady may win the race

机译：万古霉素连续输注与连续静脉血液滤过期间的间歇输注：缓慢而稳定可能会赢得比赛

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Background Vancomycin during continuous venovenous hemofiltration (CVVH) is either administered by intermittent infusion (II) or continuous infusion (CI). In this patient population, the best method to rapidly achieve target serum concentrations of 15 mcg/ml to 25 mcg/ml remains to be elucidated. We hypothesized that CI would achieve a target serum level of 15 mcg/ml to 25 mcg/ml within 24 h of the initiation of therapy more consistently than II. Methods A retrospective cohort study of adult patients admitted to the intensive care unit (ICU) between 2011 and 2014 receiving intravenous vancomycin with 24-hour serum level while on CVVH was included. Patients were excluded from this review if they had residual renal function during CVVH, were concomitantly on extracorporeal membrane oxygenation, or if the first dose of vancomycin was received six or more hours prior to the initiation of CVVH. The primary outcome was the achievement of a therapeutic level of 15mcg/ml to 25 mcg/ml by 24 hours. Results Fifty-nine patients met the inclusion criteria and 14 received CI and 45 in II. Therapeutic 24-hour levels were achieved in 14/14 versus 2/45 in CI and II, respectively (p p p p = 0.339). In the subgroup of 27 patients who received vancomycin-loading dose >20 mg/kg, mean 24-hour levels were 20.35 ± 2.78 mcg/ml for CI versus 11.8 ± 2.7 mcg/ml for II (p Conclusions The results of our study suggest that critically ill patients on CVVH treated with CI achieved the target level faster than II and consistently keep the vancomycin level within target range.
机译：背景持续静脉静脉血液滤过（CVVH）期间的万古霉素通过间歇输注（II）或连续输注（CI）给药。在该患者人群中，尚需要阐明快速达到15 mcg / ml至25 mcg / ml的目标血清浓度的最佳方法。我们假设CI在治疗开始后的24小时内将比II更稳定地达到15 mcg / ml至25 mcg / ml的目标血清水平。方法对2011年至2014年入住重症监护病房（ICU）的成年患者进行回顾性队列研究，该患者在接受CVVH时接受24小时血清万古霉素静脉注射。如果患者在CVVH期间残留肾功能，或同时进行体外膜氧合作用，或者在开始CVVH之前六个小时或更长时间接受了第一剂万古霉素，则将其排除在本评价之外。主要结果是在24小时内达到15mcg / ml至25mcg / ml的治疗水平。结果59例患者符合纳入标准，其中14例接受CI，II例接受45例。 CI和II分别达到14/14和24/45的24小时治疗水平（p p p p = 0.339）。在27名接受万古霉素负荷剂量> 20 mg / kg的患者亚组中，CI的平均24小时水平为20.35±2.78 mcg / ml，而II的平均24小时水平为11.8±2.7 mcg / ml（p结论我们的研究结果表明接受CI治疗的CVVH重症患者的目标水平快于II级，并且万古霉素水平始终保持在目标范围内。

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