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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Antithrombin Population Pharmacokinetics in Pediatric Ventricular Assist Device Patients
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Antithrombin Population Pharmacokinetics in Pediatric Ventricular Assist Device Patients

机译：小儿心室辅助装置患者的抗凝血酶群体药代动力学

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Objectives: Describe the pharmacokinetics of antithrombin in pediatric patients undergoing ventricular assist device therapy and provide dosing recommendations for antithrombin in this population. Design: A retrospective population pharmacokinetic study was designed. Setting: Large tertiary care children's hospital Subject inclusion criteria consisted of less than 19 years old. Patients: Subjects less than 19 years old undergoing therapy with a HeartWare ventricular assist device (HeartWare, Framingham, MA) or Berlin EXCOR ventricular assist device (Berlin GmbH, Berlin, Germany), who received a dose of antithrombin with a postdose antithrombin activity level from January 1, 2011, to June 30, 2017. Interventions: Population pharmacokinetic analysis and simulation using NONMEM v.7.4 (Icon, PLC, Dublin, Ireland). Measurements and Main Results: A total of 41 patients met study criteria (median age, 5.8 years [interquartile range, 1.6-9.9 yr]), and 53.7% underwent therapy with the pulsatile Berlin EXCOR pediatric ventricular assist device (Berlin Heart GmbH, Berlin, Germany). All patients received unfractionated heparin continuous infusion at a mean +/- sd dose of 29 +/- 14 U/kg/hr. A total of 181 antithrombin doses (44.1 +/- 24.6 U/kg/dose) were included, and baseline antithrombin activity levels were 77 +/- 12 U/dL. Antithrombin activity levels were drawn a median 19.9 hours (interquartile range, 8.8-41.6 hr) after antithrombin dose. A one-compartment proportional error model best fit the data, with allometric scaling of fat-free mass providing a better model fit than actual body weight. Unfractionated heparin and baseline antithrombin were identified as significant covariates. A 50 U/kg dose of antithrombin had a simulated half-life 13.2 +/- 6.6 hours. Conclusions: Antithrombin should be dosed on fat-free mass in pediatric ventricular assist device patients. Unfractionated heparin dose and baseline antithrombin activity level should be considered when dosing antithrombin in pediatric ventricular assist device patients.
机译：目的：描述抗抗凝血酶在接受心室辅助装置治疗的儿科患者的药代动力学，并为这类抗凝血酶提供给抗凝血酶的剂量推荐。设计：设计了一种回顾性的人口药代动力学研究。环境：大三级护理儿童医院纳入标准包括不到19岁。患者：少于19岁的患者接受心脏心室辅助设备（Heartware，Framingham，MA）或柏林胶质心室辅助设备（Berlin GmbH，德国）的疗法，他们接受了一剂抗凝血酶活性水平的抗凝血酶从2011年1月1日起，到2017年6月30日。干预措施：使用非梅米V.7.4的人口药代动力学分析和模拟（图标，PLC，Dublin，爱尔兰）。测量和主要结果：共有41名患者达到研究标准（中位年龄，5.8年[四分位数，1.6-9.9年）和53.7％接受脉动柏林胶虫小儿心室辅助装置（柏林柏林Heart GmbH） ， 德国）。所有患者在29 +/- 14 U / kg / HR的平均+/-14U / kg / hr处接受未分叉的肝素连续输注。包括总共181个抗抗凝血酶剂量（44.1 +/- 24.6u / kg /剂量），基线抗凝血酶活性水平为77 +/- 12u / dl。在抗凝血酶剂量后，抗凝血酶活性水平绘制了中位数19.9小时（四分位数范围，8.8-41.6小时）。一个单室比例误差模型最适合数据，具有脂肪块的各种缩放，提供比实际体重更好的模型配合。未被释放的肝素和基线抗抗凝血酶被鉴定为显着的协变量。 A 50 U / kg剂量的抗凝血酶具有模拟半衰期13.2 +/- 6.6小时。结论：对小儿心室辅助装置患者的无脂肪块应给予抗凝血酶。在小儿心室辅助装置患者中给药抗凝血酶时，应考虑未分支的肝素剂量和基线抗抗凝血酶活性水平。

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