Donoso F Alejandro, Ulloa V Daniela, Contreras E Dina, Arriagada S Daniela
Unidad de Paciente Crítico Pediátrico, Hospital Clínico Metropolitano La Florida, Santiago, Chile.
Arch Argent Pediatr. 2019 Apr 1;117(2):e121-e130. doi: 10.5546/aap.2019.eng.e121.
An adequate drug dosage at treatment initiation is particularly relevant for critically ill patients. An inadequate dosage may result in therapeutic failure, potentially severe adverse events, and unnecessary health expenditures. At present, due to the higher incidence of childhood obesity, primary care physicians are more commonly faced with this population, so they need to make appropriate therapeutic decisions. Knowledge of the resulting pharmacokinetic alterations caused by increased body fat is critical. The optimal drug dosage is not completely defined and the correct body descriptor should be used, although there is no consensus on which is the most adequate one. The objective of this update is to gain insight on pharmacokinetic alterations that affect dosage in the critically ill obese pediatric patient and, specifically, those related to the drugs most commonly used in this population during their stay in the pediatric intensive care unit.
治疗开始时给予足够的药物剂量对重症患者尤为重要。剂量不足可能导致治疗失败、潜在的严重不良事件以及不必要的医疗支出。目前，由于儿童肥胖症发病率较高，初级保健医生更常面对这一人群，因此他们需要做出适当的治疗决策。了解因体脂增加导致的药代动力学改变至关重要。尽管对于哪种是最合适的身体描述指标尚无共识，但最佳药物剂量尚未完全确定，应使用正确的身体描述指标。本次更新的目的是深入了解影响重症肥胖儿科患者剂量的药代动力学改变，特别是那些与该人群在儿科重症监护病房住院期间最常用药物相关的改变。
