scholarly journals An evaluation on the association of vancomycin trough concentration with mortality in critically ill patients: A multicenter retrospective study

2021 ◽  
Author(s):  
Jiajia Ren ◽  
Yanli Hou ◽  
Jiamei Li ◽  
Ya Gao ◽  
Ruohan Li ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Critically Ill ◽  
Trough Concentration ◽  
Critically Ill Patients ◽  
Vancomycin Trough

scholarly journals Relationship Between Mean Vancomycin Trough Concentration and Mortality in Critically Ill Patients: A Multicenter Retrospective Study

2021 ◽  
Author(s):  
Yanli Hou ◽  
Jiajia Ren ◽  
Jiamei Li ◽  
Xuting Jin ◽  
Ya Gao ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Critically Ill ◽  
Trough Concentration ◽  
Critically Ill Patients ◽  
Continuous Variable ◽  
Research Database ◽  
Categorical Variable ◽  
Icu Mortality ◽  
Vancomycin Trough ◽  
Relationship Of

Abstract Background: It remains unclear whether the mean vancomycin trough concentration (VTC) derived from the entire course of therapy is of potential benefit for critically ill patients. This study was conducted to explore the association between mean serum VTC and mortality in intensive care units (ICUs).Methods: 3,364 adult patients with two or more VTC records after receiving vancomycin therapy in the eICU Collaborative Research Database were included in this multicenter retrospective cohort study. Mean VTC was estimated using all measured VTCs and investigated as a continuous and categorical variable. Patients were categorized into four groups according to mean VTC: <10, 10–15, 15–20, and >20 mg/L. Multivariable logistic regression and subgroup analyses were performed to investigate the relationship of mean VTC with mortality.Results: After adjusting for a series of covariates, logistic regression analyses indicated that mean VTC, as a continuous variable, was positively correlated with ICU (odds ratio, 1.042, 95% confidence interval, [1.017–1.068]) and hospital (1.025 [1.004–1.046]) mortalities. As a categorical variable, mean VTC at 10–15 mg/L failed to reduce ICU mortality (1.512 [0.849–2.694]). Moreover, mean VTCs of 15–20 and >20 mg/L were significantly associated with higher ICU mortality (1.946 [1.106–3.424]; 2.314 [1.296–4.132]) than mean VTC <10 mg/L. Mean VTCs of 10–15, 15–20, and >20 mg/L were not associated with increased hospital mortality (1.154 [0.766–1.739]; 1.342 [0.896–2.011]; 1.496 [0.981–2.281]). Similar results were observed in different Acute Physiology and Chronic Health Evaluation IV score or creatinine clearance subgroups.Conclusions: Increasing mean VTC showed no benefit regarding ICU and hospital mortalities in critically ill patients. Our results suggested that continuous VTC monitoring might not guarantee vancomycin efficacy for ICU patients.

scholarly journals Relationship Between Mean Vancomycin Trough Concentration and Mortality in Critically Ill Patients: A Multicenter Retrospective Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Yanli Hou ◽  
Jiajia Ren ◽  
Jiamei Li ◽  
Xuting Jin ◽  
Ya Gao ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Trough Concentration ◽  
Critically Ill Patients ◽  
Continuous Variable ◽  
Research Database ◽  
Categorical Variable ◽  
Vancomycin Trough ◽  
Relationship Of

Background: It remains unclear whether the mean vancomycin trough concentration (VTC) derived from the entire course of therapy is of potential benefit for critically ill patients. This study was conducted to explore the association between mean serum VTC and mortality in intensive care units (ICUs).Methods: 3,603 adult patients with two or more VTC records after receiving vancomycin treatment in the eICU Collaborative Research Database were included in this multicenter retrospective cohort study. Mean VTC was estimated using all measured VTCs and investigated as a continuous and categorical variable. Patients were categorised into four groups according to mean VTC: &lt;10, 10–15, 15–20, and &gt;20 mg/L. Multivariable logistic regression and subgroup analyses were performed to investigate the relationship of mean VTC with mortality.Results: After adjusting for a series of covariates, logistic regression analyses indicated that mean VTC, as a continuous variable, was positively correlated with ICU (odds ratio, 1.038, 95% confidence interval, [1.014–1.063]) and hospital (1.025 [1.005–1.046]) mortalities. As a categorical variable, mean VTC of 10–15 mg/L was not associated with reduced ICU (1.705 [0.975–2.981]) and hospital (1.235 [0.829–1.841]) mortalities. Mean VTC of 15–20 mg/L was not correlated with a lower risk of hospital mortality (1.370 [0.924–2.029]). Moreover, mean VTCs of 15–20 and &gt;20 mg/L were significantly associated with higher ICU mortality (1.924 [1.111–3.332]; 2.428 [1.385–4.258]), and mean VTC of &gt;20 mg/L with higher hospital mortality (1.585 [1.053–2.387]) than mean VTC of &lt;10 mg/L. Similar results were observed in patients with different Acute Physiology and Chronic Health Evaluation IV score, creatinine clearance, age, and body mass index subgroups.Conclusion: Mean VTC was not associated with reduced ICU/hospital related mortality. Our results suggested that VTC monitoring might not guarantee vancomycin efficacy for ICU patients.

Relationship Between Initial Vancomycin Trough Levels and Early-Onset Vancomycin-Associated Nephrotoxicity in Critically Ill Patients

2017 ◽  
pp. 1 ◽  
Author(s):  
Masayuki Chuma ◽  
Makoto Makishima ◽  
Toru Imai ◽  
Naohiro Tochikura ◽  
Shinichiro Suzuki ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Early Onset ◽  
Vancomycin Trough ◽  
Trough Levels

scholarly journals BEDSIDE LAPAROSCOPY AS DIAGNOSTIC TOOL REVIEW OF ABDOMINAL PATHOLOGIES IN CRITICALLY ILL PATIENTS: REVIEW

2022 ◽  
Vol 6 (1) ◽  
Author(s):  
Danilo Coco ◽  
Silvana Leanza
Keyword(s):  
Retrospective Study ◽  
Diagnostic Accuracy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Laboratory Tests ◽  
Diagnostic Laparoscopy ◽  
Delayed Diagnosis ◽  
Definite Diagnosis ◽  
Imaging Results ◽  
Increase Rate

Introduction: The diagnosis of abdominal pathologies in critically ill patients is often difficult because of inconclusive laboratory tests or imaging results, or the inability to safely transfer a patient to the radiology room. These causes give a delayed diagnosis of abdominal pathology in the intensive care unit (ICU) and increase rate of morbidity and mortality. The aim of this retrospective study is to evaluate the safety and diagnostic accuracy of bedside diagnostic laparoscopy in the identification of intra-abdominal pathology in critically ill patients. Aim: The aim of this retrospective study is to evaluate the safety and diagnostic accuracy of bedside diagnostic laparoscopy in the identification of intra-abdominal pathology in critically ill patients. Materials and Methods: A  literature research was carried out including PubMed, Medline, Embase, Cochrane and Google Scholar databases to identify articles reporting on importance of diagnostic accuracy of bedside diagnostic laparoscopy in the identification of intra-abdominal pathology in critically ill patients. Conclusions: Bedside diagnostic laparoscopy represents a safe and accurate technique for diagnosing intraabdominal pathology in an ICU setting and should be taken into consideration when patient transfer to radiology or the operating room is considered unsafe or when routine radiological examinations are not conclusive enough to reach a definite diagnosis. Keywords: Bedside laparoscopy, critically ill patients, ultrasonography (US), computed tomography (CT) , emergency surgery

scholarly journals Augmented Renal Clearance in Iranian Critically Ill Patients: Retrospective Study at Masih Daneshvari Hospital

2017 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Seyed Reza Saghebi ◽  
Behrooz Farzanegan ◽  
Payam Tabarsi ◽  
Rokhsaneh Zangooi ◽  
Batoul Khoundabi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Renal Clearance ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Augmented Renal Clearance

scholarly journals Cardiovascular Safety of Clonidine and Dexmedetomidine in Critically Ill Patients after Cardiac Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Angelina Grest ◽  
Judith Kurmann ◽  
Markus Müller ◽  
Victor Jeger ◽  
Bernard Krüger ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Surgery ◽  
Retrospective Study ◽  
Mean Arterial Pressure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Low Cost ◽  
Cardiovascular Safety ◽  
Drug Infusion ◽  
Saps Ii

Purpose. The aim of this retrospective study was to assess the haemodynamic adverse effects of clonidine and dexmedetomidine in critically ill patients after cardiac surgery. Methods. 2769 patients were screened during the 30-month study period. Heart rate (HR), mean arterial pressure (MAP), and norepinephrine requirements were assessed 3-hourly during the first 12 hours of the continuous drug infusion. Results are given as median (interquartile range) or numbers (percentages). Results. Patients receiving clonidine (n = 193) were younger (66 (57–73) vs 70 (63–77) years, p=0.003) and had a lower SAPS II (35 (27–48) vs 41 (31–54), p=0.008) compared with patients receiving dexmedetomidine (n = 141). At the start of the drug infusion, HR (90 (75–100) vs 90 (80–105) bpm, p=0.028), MAP (70 (65–80) vs 70 (65–75) mmHg, p=0.093), and norepinephrine (0.05 (0.00–0.11) vs 0.12 (0.03–0.19) mcg/kg/min, p<0.001) were recorded in patients with clonidine and dexmedetomidine. Bradycardia (HR < 60 bpm) developed in 7.8% with clonidine and 5.7% with dexmedetomidine (p=0.51). Between baseline and 12 hours, norepinephrine remained stable in the clonidine group (0.00 (−0.04–0.02) mcg/kg/min) and decreased in the dexmedetomidine group (−0.03 (−0.10–0.02) mcg/kg/min, p=0.007). Conclusions. Dexmedetomidine and the low-cost drug clonidine can both be used safely in selected patients after cardiac surgery.

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