Matsushita I, Paik N S, Itaoka T, Kawamura T, Wada J
Jpn J Antibiot. 1980 Jul;33(7):705-10.
In open surgery, ampicillin (Solcillin) or cephacetrile (Celtol), 2 g for patients weighing 20 kg or more, and 1 g for those below 20 kg, was administered, and the antibiotic concentrations in blood and urine were estimated during extracorporeal circulation, from the time of operation to the admission in an intensive care unit (Group A). In other group, a total circulation volume of 0.3 mg/ml of the antibiotic was administered, based on body weight of patients and priming volumes (Group B). In Group A, blood concentration of antibiotics was so variable that it was difficult to decide additional dosage. In Group B, comparatively definite concentrations were estimated in each case. In extracorporeal circulation for a long time, it is preferable to maintain the blood concentration of antibiotic at 50 micrograms/ml, by additional antibiotic administration 90 approximately 120 minutes after the beginning of the extracorporeal circulation. In patients with preoperative subacute bacterial endocarditis, the blood concentration should be kept over 100 micrograms/ml during extracorporeal circulation.
在开放性手术中,体重20公斤及以上的患者给予氨苄西林(梭西西林)或头孢乙腈(头孢菌素)2克,体重低于20公斤的患者给予1克,从手术开始到入住重症监护病房期间,在体外循环过程中估算血液和尿液中的抗生素浓度(A组)。在另一组中,根据患者体重和预充量给予抗生素,总量为0.3毫克/毫升(B组)。在A组中,抗生素的血液浓度变化很大,难以确定额外的剂量。在B组中,每种情况下都能估算出相对确定的浓度。在长时间的体外循环中,体外循环开始后约90至120分钟通过额外给予抗生素将抗生素的血液浓度维持在50微克/毫升是较好的做法。对于术前患有亚急性细菌性心内膜炎的患者,体外循环期间血液浓度应保持在100微克/毫升以上。