Aminoglycoside Pharmacokinetic Parameters in Neurocritical Care Patients Undergoing Induced Hypothermia

• DOI: 10.1592/phco.30.7.654
• Publication Date: 2010-06-24T13:20:27Z
• Authors: Jessica M. Mercer; Ron R. Neyens
• Keywords: Elimination rate constant; Neurointensive care; Population Pharmacokinetics

Study Objective. To determine the effects of mild‐to‐moderate induced hypothermia—a neuroprotectant and/or therapeutic strategy for management intracranial hypertension in neurologically injured patients—on pharmacokinetics aminoglycoside therapy. Design . Pharmacokinetic analysis. Setting Critical care unit at a university‐affiliated hospital. Patients Three patients, aged 22, 24, and 47 years, who received tobramycin had documented levels while undergoing hypothermia more than 24 hours hypertension. Measurements Main Results. For each three predicted pharmacokinetic parameters (volume distribution, first‐order elimination rate constant, half‐life, renal drug clearance) based on population data were compared with their actual that calculated observed serum levels. All patients normal creatinine clearance, estimated according to established methods. When after first dose using one‐compartment method, all slower larger volume distribution estimates. Conclusion These findings suggest may result impaired aminoglycosides. Caution should be exercised when attempting use aminoglycosides this patient population, first‐dose considered optimize dosing interval early course Further investigation phenomenon greater numbers are needed confirm these optimal strategies hypothermia.