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Scientific article
Review
French

Adaptation posologique des medicaments couramment utilises en reanimation lors d'epuration extrarenale continue

Other titleDrugs dosing in intensive care unit during continuous renal replacement therapy
Published inNéphrologie & thérapeutique, vol. 5, no. 6, p. 533-541
Publication date2009
Abstract

Drug dosing in the intensive care unit can be challenging. Acute kidney injury (AKI) is a common complication of sepsis and a part of multiple organ dysfunction syndrome. Continuous renal replacement therapy (CRRT) is increasingly used as dialysis therapy in this critically ill population. Available data demonstrate that sepsis, AKI and different modalities of CRRT can profoundly change drugs pharmacokinetic. The severity of these changes depends on molecules characteristics (volume of distribution, plasma protein binding, molecular weight, plasma half-life, plasma clearance), patient itself (volemia, residual renal function, tissue perfusion, hepatic dysfunction) and modality of CRRT (diffusion, convection, adsorption). There are no available recommendations to adapt drug dosing in a given critically ill patient with a given modality of CRRT. It is necessary to fully understand the different methods of CRRT and drug pharmacokinetic to prescribe the appropriate dose and to avoid under or potentially toxic overdosing. Monitoring the plasma level of drug - when available - can establish a relation between the blood concentration and its effect; thus, facilitating drug dosing.

Keywords
  • *Drug Dosage Calculations
  • Humans
  • *Intensive Care Units
  • Pharmacokinetics
  • *Renal Replacement Therapy
Citation (ISO format)
BOURQUIN, Vincent et al. Adaptation posologique des medicaments couramment utilises en reanimation lors d’epuration extrarenale continue. In: Néphrologie & thérapeutique, 2009, vol. 5, n° 6, p. 533–541. doi: 10.1016/j.nephro.2009.02.010
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ISSN of the journal1769-7255
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