tailieunhanh - Báo cáo hóa học: " Retrospective evaluation of possible renal toxicity associated with continuous infusion of vancomycin in critically ill patients"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Retrospective evaluation of possible renal toxicity associated with continuous infusion of vancomycin in critically ill patients | Spapen et al. Annals of Intensive Care 2011 1 26 http content 1 1 26 Ù Annals of Intensive Care a SpringerOpen Journal RESEARCH Open Access Retrospective evaluation of possible renal toxicity associated with continuous infusion of vancomycin in critically ill patients 1 2 1 31 1 Herbert D Spapen Karin Janssen van Doorn Marc Diltoer Walter Verbrugghe Rita Jacobs Nadia Dobbeleir Patrick M Honoré1 and Philippe G Jorens3 Abstract Background Continuous infusion of vancomycin is increasingly preferred as an alternative to intermittent administration in critically ill patients. Intermittent vancomycin treatment is associated with an increased occurrence of nephrotoxicity. This study was designed to determine the incidence and risk factors of acute kidney injury AKI during continuous infusion of vancomycin. Methods This was a retrospective observational two-center cohort study in patients with microbiologically documented Gram-positive pneumonia and or bacteremia and normal baseline renal function. Vancomycin dose was adjusted daily aiming at plateau concentrations of 15-25 pg mL. AKI was defined as an increase in serum creatinine of mg dL or a to 2 times increase from baseline on at least 2 consecutive days after the initiation of vancomycin. Primary data analysis compared patients with AKI with patients who did not develop AKI. A binary logistic regression analysis using the forward stepwise method was used to assess the risk factors associated with AKI. Results A total of 129 patients were studied of whom 38 developed AKI. Patients with AKI had higher body weight 15 vs. kg p more diabetes 79 vs. 54 p and a higher vasopressor need 87 vs. 59 p . Serum vancomycin levels body weight and SAPS 3 score were identified as variables contributing to AKI. The incidence of AKI increased substantially when treatment duration was prolonged vs. days p and plasma levels exceeded 30 pg mL. .