Brown Paula, Battistella Marisa
Pharmacy Department, University Health Network, Toronto, ON M4G 2C4, Canada.
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada.
Pharmacy (Basel). 2020 Mar 9;8(1):33. doi: 10.3390/pharmacy8010033.
The use of sustained low-efficiency dialysis (SLED) as a renal replacement modality has increased in critically ill patients with both acute kidney injury (AKI) and hemodynamic instability. Unfortunately, there is a paucity of data regarding the appropriate dosing of medications for patients undergoing SLED. Dose adjustment in SLED often requires interpretation of pharmacodynamics and pharmacokinetic factors and extrapolation based on dosing recommendations from other modes of renal replacement therapy (RRT). This review summarizes published trials of antimicrobial dose adjustment in SLED and discusses pharmacokinetic considerations specific to medication dosing in SLED. Preliminary recommendation is provided on selection of appropriate dosing for medications where published literature is unavailable.
在患有急性肾损伤（AKI）且伴有血流动力学不稳定的危重症患者中，持续低效透析（SLED）作为一种肾脏替代治疗方式的应用有所增加。遗憾的是，关于接受SLED治疗患者的药物合适剂量的数据匮乏。SLED中的剂量调整通常需要解读药效学和药代动力学因素，并根据其他肾脏替代治疗（RRT）模式的给药建议进行推断。本综述总结了已发表的关于SLED中抗菌药物剂量调整的试验，并讨论了SLED中药物给药特有的药代动力学注意事项。对于尚无发表文献的药物，提供了关于选择合适给药剂量的初步建议。
