Therapeutics Research Centre, School of Medicine, University of Queensland, Princess Alexandra Hospital, Woollongabba, QLD 4102, Australia.
Curr Pharm Biotechnol. 2011 Dec;12(12):2037-43. doi: 10.2174/138920111798808239.
There is pressing need to better understand pharmacokinetics in critically ill patients. This will aid clinicians in selecting optimal dosing regimens. Pharmacokinetic studies are difficult in this population due to the heterogeneity of the patients and the practical issues of research involving critically ill patients. Therapeutic drug monitoring is routinely performed to guide dosing for aminoglycoside and glycopeptide antibiotics. Expanding its use to other drug classes could provide new therapeutic advantages. Plasma concentration may not always reflect tissue distribution in critically ill patients. Microdialysis is a technique that can be applied in the Intensive Care Unit to measure tissue concentrations and provide further insights to antimicrobial therapy for critically ill patients. Finally, the application of population pharmacokinetic analysis in studies in critically ill patients may identify factors affecting pharmacokinetics and enhance drug dosing regimens for varied patient groups.
目前迫切需要更好地了解危重症患者的药代动力学。这将有助于临床医生选择最佳的给药方案。由于患者的异质性和涉及危重症患者的研究的实际问题，在该人群中进行药代动力学研究具有一定难度。治疗药物监测通常用于指导氨基糖苷类和糖肽类抗生素的给药。将其应用于其他药物类别可能会提供新的治疗优势。在危重症患者中，血浆浓度并不总是反映组织分布。微透析是一种可在重症监护病房（ICU）中应用的技术，可测量组织浓度，并为危重症患者的抗菌治疗提供更深入的见解。最后，在危重症患者研究中应用群体药代动力学分析可以确定影响药代动力学的因素，并增强不同患者群体的药物给药方案。
