血药浓度监测在ECMO治疗中的研究进展  

Significance of blood drug concentration monitoring in ECMO therapy for critically ill patients

作　　者：鄂俊嘉 于健[2] 张磊[2] Junjia;Yu Jian;Zhang Lei(Dalian Mediacal of University;Department of Critical Care Medicine,The Second Affiliated Hospital of Dalian Medical University,Dalian,China.)

机构地区：[1]大连医科大学 [2]大连医科大学附属第二医院重症医学科

出　　处：《实用休克杂志(中英文)》2024年第6期356-359,364,共5页Journal of Practical Shock

基　　金：大连医科大学附属第二医院青年医护临床技术能力提升项目(项目编号:2024lcjsyl27)

摘　　要：体外膜肺氧合通过提供持续的心肺功能替代支持,能显著提高危重症患者的手术救治成功率。然而,其辅助治疗患者的院内死亡率仍处于较高水平,主要归于相关并发症(包括继发感染、凝血功能障碍及多器官衰竭)的发生。此外,体外膜肺氧合治疗会引发复杂的药代动力学改变,导致患者血药浓度呈现显著波动,这种药代动力学干扰效应直接影响临床疗效与预后转归。因此,对接受体外膜肺氧合治疗的患者开展治疗药物监测有重要的临床价值,能协助临床医师优化个体化给药方案,有效控制药物不良反应并改善患者预后。Extracorporeal membrane oxygenation technology has become an instrumental modality through its exceptional cardiopulmonary support capabilities,offering vital life-sustaining intervention for patients experiencing severe cardiopulmonary failure.Nevertheless,the mortality rate among extracorporeal membrane oxygenation-treated patients persists at elevated levels,primarily attributable to treatment-associated complications including infection,hemorrhage,and multi-organ dysfunction.Notably,it implementation induces substantial pharmacokinetic alterations,particularly in blood drug concentration profiles,with these pharmacodynamic modifications demonstrating direct correlations with therapeutic efficacy and patient prognosis.Consequently,therapeutic drug monitoring constitutes a critical component of extracorporeal membrane oxygenation management protocols,enabling clinicians to optimize therapeutic regimens through pharmacokinetic guidance and thereby improve clinical outcomes in this vulnerable patient population.

关 键 词：体外膜肺氧合 血药浓度监测 呼吸衰竭 循环衰竭 

分 类 号：R969.1[医药卫生—药理学]