体外膜肺氧合对危重患者体内万古霉素药动学与剂量的影响

Effects of Extracorporeal Membrane Oxygenation Life Support on Vancomycin Pharmacokinetics and Dosing Strategy in Critically Ill Patients

万古霉素是治疗耐甲氧西林金黄色葡萄球菌(MRSA)感染的首选药物。因存在肾毒性风险,万古霉素治疗剂量存在个体差异,且与患者体内万古霉素药动学密切相关。基于抗菌药物及时、合理使用的重要性,该文结合国内外指南、专家共识及以往相关研究,综述使用体外膜肺氧合(ECMO)期间万古霉素体内药动学与剂量变化,以期为使用ECMO的危重患者安全合理使用万古霉素提供参考。

Vancomycin is the first-class drug against methicillin-resistant Staphylococcus aureus(MRSA)infection.Due to its nephrotoxicity properties,there are significant differences in personal dosage among patients during vancomycin treatment,which also highly related with the vancomycin pharmacokinetic(PK)parameters of patients.It is important to use antibacterial drugs timely and reasonably.Combined with domestic and foreign guidelines,expert consensus,and related researches in past years,this article reviewed vancomycin pharmacokinetics,dosing changes during extracorporeal membrane oxygenation(ECMO)life support,in order to provide references for the clinical use of vancomycin among ECMO supported critically ill patients.