Pharmacokinetics and pharmacodynamics in critically ill patients

Varghese, Julie M., Roberts, Jason A. and Lipman, Jeffrey (2010) Pharmacokinetics and pharmacodynamics in critically ill patients. Current Opinion in Anesthesiology, 23 4: 472-478. doi:10.1097/ACO.0b013e328339ef0a

Author Varghese, Julie M.
Roberts, Jason A.
Lipman, Jeffrey
Title Pharmacokinetics and pharmacodynamics in critically ill patients
Journal name Current Opinion in Anesthesiology   Check publisher's open access policy
ISSN 0952-7907
Publication date 2010-08
Sub-type Article (original research)
DOI 10.1097/ACO.0b013e328339ef0a
Volume 23
Issue 4
Start page 472
End page 478
Total pages 7
Place of publication London
Publisher Lippincott-Rave
Collection year 2011
Language eng
Formatted abstract
Purpose of review: The purpose of this review is to highlight the recently published studies in the area of pharmacokinetics and pharmacodynamics in critically ill patients and ascertain the relevance to clinical practice.

Recent findings:
The majority of the published studies in this area were related to antibiotics and this will form the main focus of this review. A number of studies have focused on antibiotic concentrations at various target sites of infection or other tissue sites including cerebrospinal fluid, peritoneal fluid and burns tissues. The administration of time-dependent antibiotics using continuous infusion has also been the subject of recently published studies which support the superior achievement of pharmacodynamic targets using continuous infusion compared with bolus dosing. Antibiotic dosing during renal replacement therapies, mainly during extended daily dialysis (EDD) and during other forms of extracorporeal techniques including extracorporeal membrane oxygenation (ECMO), have also been described in a few recent studies and case reports.

Studies have shown that critically ill patients display large variations in pharmacokinetics mainly due to altered pathophysiology. An understanding of the pathophysiological changes that occur in critically ill patients is essential to optimize dosing particularly to achieve the pharmacodynamic targets for antibiotics.
Keyword antibiotics
continuous infusion
renal replacement therapy
target site
Extracorporeal membrane oxygenation
Renal Replacement Therapy
Extended daily dialysis
Intravenous Ciprofloxacin
Septic Patients
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 14 times in Thomson Reuters Web of Science Article | Citations
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Created: Sun, 25 Jul 2010, 00:07:36 EST