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目的探讨行连续性肾替代疗法(CRRT)的危重患者应如何调整万古霉素的剂量。方法针对1例脓毒症合并多器官功能障碍综合征(MODS)的患者,从CRRT模式和剂量对万古霉素清除的影响及万古霉素的药代动力学特点两方面对其进行分析。结果 CRRT下万古霉素必须进行剂量调整。结论危重症患者,尤其是在接受CRRT时,其药物动力学出现显著改变,应根据抗生素本身在危重患者的药代动力学/药效动力学特点对药物剂量进行适当的调整,不但有利于发挥更好的抗菌作用,也有利于避免副作用。
Objective To investigate how to adjust the dosage of vancomycin in critically ill patients undergoing continuous renal replacement therapy (CRRT). Methods One patient with sepsis complicated with multiple organ dysfunction syndrome (MODS) was analyzed in terms of the effects of CRRT mode and dose on vancomycin clearance and vancomycin pharmacokinetics. Results The dosage of vancomycin must be adjusted for CRRT. Conclusions In patients with critical illness, the pharmacokinetics of CR patients are significantly changed. The dosage of antibiotics should be properly adjusted according to the pharmacokinetic / pharmacodynamic characteristics of the antibiotics themselves, which not only helps to exert their influence Better antibacterial effect, but also help to avoid side effects.