目的:评估不同时间滴注静脉局部肢体灌注(IVRLP)灌注液的滑膜阿米卡星浓度是否存在差异。
方法:7匹健康马。
方法:在交叉研究设计中,马通过头静脉接受2个IVRLP和2g阿米卡星,用0.9%NaCl稀释至60mL。灌注液的滴注在1分钟(技术1)和5分钟(技术5)时间段内施用。在灌注液滴注后的时间(T)5、10、15、20、25和30分钟测量RCJ内阿米卡星的浓度。在T0、5、10、15、20、25、29分钟测量阿米卡星的全身浓度,和止血带移除后1分钟(T31)。用荧光偏振免疫法测定阿米卡星浓度。
结果:技术1的RCJ内阿米卡星的中位数最大浓度(CMAX)为338.4µg/mL(范围,60至4,925µg/mL),而技术5的CMAX中位数更高,为694.8µg/mL(范围,169.2至3,410µg/mL;P=.398)。技术1与技术5相比,随着时间的推移,阿米卡星的血液浓度更高(P=.004)。
结论:在进行IVRLP时,以不同的速率给药灌注液并没有显着影响RCJ内阿米卡星的滑膜浓度。然而,当灌注液施用超过1分钟时,注意到全身渗漏增加,这可能会影响更大一组马的滑膜浓度。
OBJECTIVE: To evaluate if a difference in synovial amikacin concentrations exists in the radiocarpal joint (RCJ) following different durations of instillation of an IV regional limb perfusion (IVRLP) perfusate.
METHODS: 7 healthy horses.
METHODS: Horses received 2 IVRLPs with 2 g amikacin diluted to 60 mL with 0.9% NaCl via the cephalic vein in a crossover study design with a wash-out period between procedures. Instillation of the perfusate was administered over a 1-minute (technique 1) and 5-minute (technique 5) period. Concentrations of amikacin within the RCJ were measured at time (T) 5, 10, 15, 20, 25, and 30 minutes after instillation of the perfusate. Systemic concentrations of amikacin were measured at T0, 5, 10, 15, 20, 25, 29 minutes, and 1 minute after tourniquet removal (T31). Amikacin concentrations were determined by fluorescence polarization immunoassay.
RESULTS: The median maximum concentration (CMAX) of amikacin within the RCJ for technique 1 was 338.4 µg/mL (range, 60 to 4,925 µg/mL), while the median CMAX for technique 5 was higher at 694.8 µg/mL (range, 169.2 to 3,410 µg/mL; P = .398). There was a higher amikacin blood concentration over time for technique 1 compared to technique 5 (P = .004).
CONCLUSIONS: Administration of perfusate at different rates did not significantly affect synovial concentration of amikacin within the RCJ when performing IVRLP. However, increased systemic leakage was noted when the perfusate was administered over 1 minute, which might affect synovial concentrations in a larger group of horses.