Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.
McMaster Centre for Transfusion Research, McMaster University, Hamilton, Canada.
Am J Clin Pathol. 2017 Dec 20;149(1):76-81. doi: 10.1093/ajcp/aqx145.
Cyclosporine is often monitored by drug levels drawn through central venous catheters (CVCs), which may be falsely elevated due to reversible drug adsorption onto the catheter. Therefore, we assessed the correlation between cyclosporine levels drawn peripherally and through CVCs.
Bone marrow transplantation patients had a weekly collection of both peripheral and CVC draws from dual-lumen catheters simultaneously to assess cyclosporine levels after research ethics approval. Our primary outcome was the proportion of paired samples that were incongruent-defined as the mean of the CVC level being greater than 2 standard deviations from the peripheral level mean.
After approaching 27 eligible patients, 20 patients (77.8%) provided samples. Of 53 paired samples, seven were incongruent (13.2%). Peripheral and CVC levels correlated (r = 0.91) and agreed well.
Despite potential for preanalytical error due to adsorption, cyclosporine infusion and monitoring via CVCs produce results similar to monitoring via peripheral blood draws.
环孢素通常通过中心静脉导管 (CVC) 抽取血药浓度来监测，但由于药物可被可逆性吸附至导管，因此可能导致血药浓度假性升高。因此，我们评估了经外周和 CVC 抽取血样中环孢素浓度之间的相关性。
在获得研究伦理批准后，骨髓移植患者同时从双腔导管中抽取外周和 CVC 每周采集一次样本，以评估环孢素水平。我们的主要结局是不一致的配对样本比例-定义为 CVC 水平的平均值比外周水平平均值高 2 个标准差。
在接近 27 名符合条件的患者后，有 20 名患者（77.8%）提供了样本。在 53 对配对样本中，有 7 个样本不一致（13.2%）。外周和 CVC 水平呈正相关（r = 0.91），且一致性良好。
尽管由于吸附作用存在潜在的分析前误差，但通过 CVC 输注和监测环孢素与通过外周血样监测产生的结果相似。
