Abstract：
Patients treated with ECMO are at great risk of nosocomial infections, and around 10% of isolates are gram-positive pathogens. Linezolid (LZD) is effective in the treatment of these infections but appropriate dosing is challenging. The aim was to evaluate the occurrence of thrombocytopenia during ECMO when treated with LZD. An LZD trough concentration of 8 mg/L was set as the cutoff value for thrombocytopenia occurrence among critically ill patients who received parenteral LZD therapy at a dose of 600 mg every 8 h during ECMO. Eleven patients were included in this prospective observational study. Median LZD trough concentrations were 7.85 (interquartile range (IQR), 1.95-11) mg/L. Thrombocytopenia was found in 81.8% of patients. Based on the median LZD trough concentrations cutoff value, patients were divided into two groups, 1.95 (IQR, 0.91-3.6) and 10.3 (IQR, 9.7-11.7) mg/L, respectively. Median platelet values differed significantly between groups on admission, ECMO day 0, ECMO day 1, and LZD sampling day [194 and 152.5, (p < 0.05)], [113 and 214, (p < 0.05)], [76 and 147.5, (p < 0.01)], and [26 and 96.5, (p < 0.01)], respectively. Duration of LZD therapy was similar between the groups. Significant platelet reduction was observed in both groups, emphasizing the need for closer monitoring to prevent LZD-associated thrombocytopenia.
摘要：
接受ECMO治疗的患者有很大的医院感染风险,大约10%的分离株是革兰氏阳性病原体。利奈唑胺（LZD）可有效治疗这些感染，但适当的剂量是具有挑战性的。目的是评估用LZD治疗时ECMO期间血小板减少症的发生。在ECMO期间每8小时接受600mg剂量的肠胃外LZD治疗的危重患者中，将LZD谷浓度设定为8mg/L作为血小板减少症发生的临界值。该前瞻性观察研究包括11名患者。LZD谷浓度中位数为7.85(四分位数间距(IQR)，1.95-11)mg/L81.8%的患者出现血小板减少。根据LZD谷浓度的中值截止值，患者分为两组，1.95(IQR，0.91-3.6)和10.3(IQR，9.7-11.7)mg/L,分别。入院时各组血小板中值有显著差异，ECMO第0天，ECMO第1天和LZD采样日[194和152.5，（p<0.05）]，[113和214，(p<0.05)]，[76和147.5，（p<0.01）]，和[26和96.5，(p<0.01)]，分别。两组之间LZD治疗的持续时间相似。两组均观察到血小板明显减少，强调需要密切监测以预防LZD相关的血小板减少症。
