Fuquay D, Koup J, Epstein M F, Smith A L
Dev Pharmacol Ther. 1981;3(4):214-21. doi: 10.1159/000457445.
To determine whether an exchange transfusion increases the rate of elimination of gentamicin, we measured drug (and bilirubin) concentration either before and during, or during and after a standard two-volume exchange procedure in 7 newborns. In an additional 5 infants, serum was obtained only on initiation and conclusion of the procedure. The mean decrement in serum gentamicin concentration with the procedure was 2.2 micrograms/ml; this was 25.7% of the original mean concentration. The mean elimination rate constant during the procedure was 0.342 h-1, a value significantly greater (p = 0.013) than the mean rate before or after the procedure, 0.104 h-1. We conclude that the exchange transfusion procedure significantly increases the rate of gentamicin elimination. The decrement produced by the procedure may result in subtherapeutic concentrations, if the initial values are marginally efficacious.
为了确定换血疗法是否会提高庆大霉素的清除率，我们在7名新生儿的标准双容量换血过程中或过程前后测量了药物（和胆红素）浓度。另外5名婴儿仅在换血开始和结束时采集血清。换血过程中血清庆大霉素浓度的平均下降幅度为2.2微克/毫升；这是原始平均浓度的25.7%。换血过程中的平均清除率常数为0.342 h⁻¹，该值显著高于（p = 0.013）换血前或后的平均清除率0.104 h⁻¹。我们得出结论，换血疗法显著提高了庆大霉素的清除率。如果初始值仅勉强有效，那么换血过程导致的浓度下降可能会导致治疗浓度不足。
