Can bioimpedance determine the volume of distribution of antibiotics in sepsis

摘要: The relationship between the volume of distribution, assessed according to two-compartmental pharmacokinetic model, and extracellular water estimated by bioimpedance was studied in mechanically ventilated patients with sepsis capillary leak. A prospective observational study performed a twenty-bed general intensive care unit university hospital. Patients received either vancomycin (n = 16) or netilmicin 12) for more than 48 hours. Those ascites, pleural effusion, on renal replacement therapy haemodynamic instability were excluded. Serum concentrations drugs taken analysis before, 1 hour 4 hours after 30 minute infusion. Bioimpedance measurement at time third sampling. protocol repeated 24 Fluid balance during interval recorded. Extracellular increased represented 45.6 46.6% total body correlated change (r 0.82, P < 0.0001) 0.74, 0.0001). Volumes distribution (0.677 +/- 0.339 l/kg) (0.505 0.172 compared normal values. correlation demonstrated (Vd(area)) extra cellular water/total ratio 0.70, central compartment (V1) 0.60, 0.003). above recommended therapeutic range detected 81.2% 50% netilmicin. Increased volumes can be measurements but are not associated requirements higher dosage glycopeptide aminoglycoside antibiotics.