Models are mathematical tools used to describe real-world features. Therapeutic interventions in the field of critical care medicine may easily be translated into such models. Indeed, numerous variables influencing drug pharmacokinetics and pharmacodynamics are systematically documented in the intensive care unit over time. Organ failure, fluid shifts, other drug administration, and renal replacement therapy may cause changes in physiological values, such as body weight and composition, temperature, serum protein levels, arterial pH, and renal or hepatic function. Trials assessing the efficacy and safety of novel drugs usually exclude critically ill patients, and guidelines regarding drug dosage rarely apply to such patients. Modeling in the critically ill may allow physicians to inform decisions related to therapeutic interventions, particularly relating to infectious diseases. However, few clinicians are familiar with these methods. Here, we present a current overview of population pharmacokinetic and pharmacodynamic models applicable in critically ill patients aimed at nonspecialists and then emphazize recent potential of modeling for optimizing treatments and care in the intensive care unit.
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http://dx.doi.org/10.1016/j.jcrc.2015.09.002 | DOI Listing |
Emergencias
December 2024
Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seúl, República de Corea. Department of Digital Health, SAIHST, Sungkyunkwan University, Seúl, República de Corea.
Objective: To develop a Metabolic Derangement Score (MDS) based on parameters available after initial testing and assess the score's ability to predict survival after out-of hospital cardiac arrest (OHCA) and the likely usefulness of extracorporeal life support (ECLS).
Methods: A total of 5100 cases in the Korean Cardiac Arrest Research Consortium registry were included. Patients' mean age was 67 years, and 69% were men.
Acta Pharm Sin B
December 2024
Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Oxaliplatin (OXA), a platinum-based chemotherapeutic agent, remains a mainstay in first-line treatments for advanced colorectal cancer (CRC). However, the eventual development of OXA resistance represents a significant clinical challenge. In the present study, we demonstrate that the aldo-keto reductase 1C1 (AKR1C1) is overexpressed in CRC cells upon acquisition of OXA resistance, evident in OXA-resistant CRC cell lines.
View Article and Find Full Text PDFResusc Plus
January 2025
Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
Aim: To assess the clinical outcomes of patients with out-of-hospital cardiac arrest attended by prehospital critical care teams compared to non-critical care teams.
Methods: This review was prospectively registered with PROSPERO and the eligibility criteria followed a PICOST framework for ILCOR systematic reviews. Prehospital critical care was defined as any provider with enhanced clinical competencies beyond standard advanced life support algorithms and dedicated dispatch to critically ill patients.
J Soc Cardiovasc Angiogr Interv
December 2024
Department of Pediatric Cardiology, Wilhelmina Children's Hospital, University Medical Center of Utrecht, Utrecht, the Netherlands.
Background: Three-dimensional rotational angiography (3DRA) is a promising advancement to guide cardiac catheterizations. It is used with restraint in critically ill infants with congenital heart disease (CHD) due to the lack of research conducted within this patient group.
Methods: Data of all infants with CHD and a body weight <5 kg who underwent cardiac catheterization with the use of 3DRA between November 2011 and April 2021 were retrospectively analyzed.
Zhonghua Yi Xue Za Zhi
January 2025
Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai Medical Center of Kidney, Shanghai200032, China.
To investigate anticoagulation effects of nafamostat mesylate(NM) in sustained low-efficiency dialysis (SLED) and its relevant factors. Critically ill patients with kidney disease who were admitted to Zhongshan Hospital Affiliated to Fudan University and underwent SLED treatment from May to August 2024 were retrospectively included. Baseline clinical data were collected, and the activated partial thromboplastin time (APTT) and activated clotting time (ACT) were measured at the arterial end, before the filter, and at the venous end two hours post-NM anticoagulation treatment.
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