Comparison of arterial and venous blood samples for the diagnosis of bacteremia in critically ill patients

Prolonged intermittent renal replacement therapy (PIRRT) is an increasingly adopted method of renal replacement in critically ill patients. Like continuous renal replacement therapy, PIRRT can alter the pharmacokinetics (PK) of many drugs. In this setting, dosing data for antibiotics like benzylpenicillin are lacking. In order to enable clinicians to prescribe benzylpenicillin safely and effectively, knowledge of the effects of PIRRT on the plasma PK of benzylpenicillin is required. Herein, we describe the PK of benzylpenicillin in 2 critically ill patients on PIRRT for the treatment of penicillin-susceptible Staphylococcus aureus bacteremia complicated by infective endocarditis. Blood samples were taken for each patient taken over dosing periods during PIRRT and off PIRRT. Two-compartment PK models described significant differences in the mean clearance of benzylpenicillin with and without PIRRT (6.61 vs. 3.04 L/h respectively). We would suggest a benzylpenicillin dose of 1,800 mg (3 million units) every 6-h during PIRRT therapy as sufficient to attain PK/pharmacodynamic target.

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Pharmacokinetic Optimisation of Aminophylline Infusions in Critically Ill Patients

Anaesthesia and Intensive Care ◽

10.1177/0310057x8301100307 ◽

1983 ◽

Vol 11 (3) ◽

pp. 220-227 ◽

Cited By ~ 1

Author(s):

K. F. Ilett ◽

R. L. Nation ◽

B. Silbert ◽

T. E. Oh

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Venous Blood ◽

Plasma Concentrations ◽

Sampling Time ◽

Infusion Therapy ◽

Plasma Theophylline ◽

Total Body ◽

Theophylline Kinetics ◽

Body Clearance

The method of Chiou et al.4 was used to predict theophylline kinetics in eleven critically ill patients with either acute severe asthma or bronchoconstriction. Following the commencement of an accurately metered infusion of aminophylline, venous blood samples were taken at approximately 1, 5 hours and 7-12 hours for measurement of plasma theophylline concentration. The 1- and 5-hour levels were used to estimate total body clearance and plasma concentration of theophylline at the 7-12-hour sampling time. Using these values, the infusion rate was adjusted if necessary and the protocol repeated. Initial predictions were unreliable in two patients because of continued absorption of theophylline from pre-infusion therapy with aminophylline suppositories or slow-release theophylline tablets. In the remaining studies there was a significant correlation (y = 0.9x + 0.55, r2 = 0.93, p < 0.01, n = 19) between predicted and actual plasma concentrations at the 7-12-hour sampling time. In three patients, sequential estimates of theophylline clearance showed an approximate twofold variation and in another two patients, there was evidence of concentration-and/or time-dependent theophylline kinetics.

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Value of continuous monitoring of mixed venous blood oxygen saturation in the management of critically ill patients

Critical Care Medicine ◽

10.1097/00003246-198602000-00011 ◽

1986 ◽

Vol 14 (2) ◽

pp. 132-134 ◽

Cited By ~ 30

Author(s):

AZMY R. BOUTROS ◽

HARLES LEE

Keyword(s):

Oxygen Saturation ◽

Critically Ill ◽

Critically Ill Patients ◽

Continuous Monitoring ◽

Venous Blood ◽

Mixed Venous Blood ◽

Blood Oxygen ◽

Blood Oxygen Saturation ◽

Mixed Venous

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Use of blood cultures in critically ill patients

Critical Care Nurse ◽

10.4037/ccn2000.20.1.45 ◽

2000 ◽

Vol 20 (1) ◽

pp. 45-50 ◽

Cited By ~ 1

Author(s):

R Henker

Keyword(s):

Polymerase Chain Reaction ◽

Critically Ill ◽

Critically Ill Patients ◽

New Technology ◽

Infectious Agent ◽

Blood Cultures ◽

Chain Reaction ◽

Blood Samples ◽

Polymerase Chain ◽

Timely Treatment

Infection, bacteremia, and sepsis are frequent complications in critically ill patients. Ideally, the infectious agent is readily identified to facilitate timely treatment to promote the patient's recovery. Use of blood cultures is one method of identifying the pathogen. Fever is the primary indicator for obtaining blood samples for culture, but other indicators may be considered, depending on the patient's medical history and condition. Use of appropriate techniques when collecting blood samples for culture will decrease contamination and improve the likelihood of identification of the infectious agent. One new technique being tested for the identification of pathogens that cause bacteremia involves genetic technology and the polymerase chain reaction. The polymerase chain reaction is used to identify the DNA of bacteria that are present in the blood. Blood cultures may not always result in identification of the pathogen because the organism may not grow once placed in culture medium. This new method that uses the polymerase chain reaction may be more sensitive than blood cultures because it requires only DNA from bacteria. Although early studies have not been conclusive in terms of the benefits of this new technology, additional research will improve methods for identification of pathogens in critically ill patients.

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CORRELATION OF VENOUS BLOOD GAS AND PULSE OXIMETRY WITH ARTERIAL BLOOD GAS IN CRITICALLY ILL PATIENTS

10.36106/ijsr/6820551 ◽

2021 ◽

pp. 1-3

Author(s):

Sritam Mohanty ◽

Rangaraj Setlur ◽

Jyoti Kumar Sinha

Keyword(s):

Pulse Oximetry ◽

Critically Ill ◽

Critically Ill Patients ◽

Venous Blood ◽

Blood Gas Analysis ◽

Gas Analysis ◽

Blood Gas ◽

Gold Standard Method ◽

Arterial Blood Gas ◽

Arterial Blood

Introduction: Arterial blood gas (ABG) analysis is the gold standard method and frequently performed intervention to evaluate acid-base status along with adequacy of ventilation and oxygenation among patients with predominantly critical / acute diseases. Aims And Objectives: The aim of this study is to evaluate the correlation of VBG analysis and pulse oximetry (SpO2) with ABG analysis in critically ill patients. Materials And Methods:Intensive Care Unit (ICU), Command Hospital (Eastern Command), Kolkata, Adult patients requiring arterial blood gas analysis, JAN 2018 –JUNE 2019, 100 critically ill patients and Age – 18yrs and older, Sex – Either sex. Conclusion: In this study population of critically ill patients, pH and pCO2 on VBG analysis correlated with pH and pCO2 on ABG analysis. The SpO2 correlated well with pO2 on ABG analysis

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Alterations in circadian rhythm of serum thyrotropin in critically ill patients

Acta Endocrinologica ◽

10.1530/acta.0.1270018 ◽

1992 ◽

Vol 127 (1) ◽

pp. 18-22 ◽

Cited By ~ 5

Author(s):

Nicola Custro ◽

Vincenza Scafidi ◽

Alberto Notarbartolo

Keyword(s):

Circadian Rhythm ◽

Critically Ill ◽

Critically Ill Patients ◽

Healthy Subjects ◽

Serum Concentrations ◽

Statistical Methodology ◽

Blood Samples ◽

The Mean ◽

Disease Analysis ◽

Serum Tsh

To evaluate the 24-h pattern of serum thyrotropin (TSH) in critically ill patients, we measured serum concentrations of TSH in blood samples collected every 2 h for 24 h from nine patients (six with malignancy, two with liver cirrhosis, one with chronic renal failure), who had subnormal levels of both triiodothyronine (T3) and thyroxine (T4), in the absence of history, symptoms or signs of thyroid disease. Analysis of the data, performed using a second-order inferential statistical methodology for rhythmometry (cosinor method), demonstrated that critically ill patients still had daily oscillations of serum TSH which significantly adapted to the function approximating the circadian rhythms (R2 = 74.3%). However, the mean level (mesor) in the rhythm of the patients was found to be significantly lower than that of healthy subjects (0.96 vs 2.18 mU/l); the amplitude of rhythmical daily variations also was lower in patients than in healthy subjects (0.23 vs 0.56 mU/l), even though the amplitude/mesor ratio was similar (23% vs 26%). Lastly, the highest level in the TSH rhythm of the patients was found to be in the late afternoon, in contrast to healthy subjects, who had a TSH surge after midnight. Although these alterations are consistent with the existence of a dysregulation at suprahypophyseal level in critically ill patients, it remains to be established whether the state of low T3 and T4 may be ascribed to anomalous circadian rhythm of TSH.

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