Relationship between hemodynamic and vital support measures and pharmacokinetic variability of amikacin in critically ill patients with sepsis

Critical Care Medicine
G Lugo, G Castañeda-Hernández

Abstract

To examine the relationship between aminoglycoside disposition kinetics and hemodynamic response to sepsis, as well as vital support therapy, in critically ill patients with sepsis. Cross-sectional study of critically ill patients with sepsis undergoing physiologic and aminoglycoside pharmacokinetic monitoring. Ten-bed general intensive care unit in a tertiary care center. Thirty consecutive critically ill patients who had Gram-negative sepsis treated with amikacin and who were undergoing hemodynamic monitoring. Clinical, hemodynamic, oxygenation, and amikacin pharmacokinetic data were obtained simultaneously in each patient during aminoglycoside therapy. Aminoglycoside pharmacokinetic values were estimated from serum amikacin concentration-time data using a nonlinear least squares regression computer program, assuming a one-compartment infusion pharmacokinetic model. Individual pharmacokinetic values were subjected to statistical analysis to explain their variability. Selection of the subset of variables to be used in the final model was performed by combining principal component analysis and multiple stepwise linear regression. The mean prediction error and the root mean square error, as expressions of bias and precision, wer...Continue Reading

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