| Title |
Daily vancomycin dose requirements as a continuous infusion in obese versus non-obese SICU patients
|
|---|---|
| Published in |
Critical Care, July 2016
|
| DOI | 10.1186/s13054-016-1363-9 |
| Pubmed ID | |
| Authors |
Hsin Lin, Daniel Dante Yeh, Alexander R. Levine |
| Abstract |
Limited data are available assessing vancomycin concentrations in obese critically ill patients. Currently, there are no studies evaluating dosing requirements in this population who receive vancomycin administered as a continuous infusion (CI). The aim of this study was to assess whether there was a difference in the weight-based maintenance dose required to reach a therapeutic vancomycin concentration at 24 hours when given as a CI in obese versus non-obese critically ill patients. A retrospective cohort study of adult obese patients admitted to the SICU between 2013 and 2015 receiving a vancomycin CI (CIV), and with 24-hour serum measurements were included. Obese patients (body mass index (BMI) ≥35 kg/m(2)) were matched with non-obese patients (BMI <30 kg/m(2)) based on renal function, age and acute physiology and chronic health evaluation (APACHE)-II score at admission. All patients in this study received a loading dose of 25 mg/kg then a maintenance dose based on renal function according to the protocol. The study was approved by the Institutional Review Board. The primary outcome was the weight-based total daily maintenance dose required to achieve a vancomycin level of 20 mg/L. The secondary endpoints included the achievement of a therapeutic level at 24 hours. Twenty-six matched pairs of patients met the inclusion criteria. Of these, 17 pairs had preserved renal function and 9 pairs required continuous venovenous hemofiltration. Mean BMI was 40.9 kg/m(2) in obese and 24.8 kg/m(2) in non-obese patients. To achieve a vancomycin concentration of 20 mg/L, the weight-based daily maintenance dose in obese patients was 25.6 mg/kg versus 43.8 mg/kg in non-obese patients (p <0.01). Therapeutic 24-hour levels were achieved in 24/26 obese versus 23/26 no-obese patients (p = 0.63). Mean 24-hour vancomycin level was 20.3 ± 3.81 mcg/ml in obese compared to 20.03 ± 3.79 mcg/ml in non-obese patients (p = 0.77). Mean daily maintenance doses required to achieve a level of 20 mcg/ml were 2961 ± 1670 mg in obese compared to 3189 ± 1600.69 mg in non-obese (p = 0.61). The results of our study suggest that critically ill obese patients treated with CIV required a significantly lower maintenance dose per unit of body weight than non-obese patients to achieve the same target level. |
X Demographics
The data shown below were collected from the profiles of 31 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 5 | 16% |
| Saudi Arabia | 2 | 6% |
| United Kingdom | 2 | 6% |
| Brazil | 2 | 6% |
| Argentina | 1 | 3% |
| El Salvador | 1 | 3% |
| Japan | 1 | 3% |
| Netherlands | 1 | 3% |
| Germany | 1 | 3% |
| Other | 2 | 6% |
| Unknown | 13 | 42% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 18 | 58% |
| Practitioners (doctors, other healthcare professionals) | 11 | 35% |
| Science communicators (journalists, bloggers, editors) | 2 | 6% |
Mendeley readers
The data shown below were compiled from readership statistics for 61 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 61 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 9 | 15% |
| Student > Ph. D. Student | 7 | 11% |
| Student > Master | 7 | 11% |
| Student > Bachelor | 5 | 8% |
| Professor > Associate Professor | 5 | 8% |
| Other | 16 | 26% |
| Unknown | 12 | 20% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 26 | 43% |
| Pharmacology, Toxicology and Pharmaceutical Science | 10 | 16% |
| Nursing and Health Professions | 4 | 7% |
| Environmental Science | 1 | 2% |
| Unspecified | 1 | 2% |
| Other | 4 | 7% |
| Unknown | 15 | 25% |
Attention Score in Context
This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 September 2019.
All research outputs
#2,423,049
of 25,728,855 outputs
Outputs from Critical Care
#2,099
of 6,613 outputs
Outputs of similar age
#41,805
of 368,469 outputs
Outputs of similar age from Critical Care
#64
of 114 outputs
Altmetric has tracked 25,728,855 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,613 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.7. This one has gotten more attention than average, scoring higher than 68% of its peers.
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