The comparative study on different intravenous time of imipenem and cilastatin for acute respiratory distress syndrome

ZHANG Weiwei; ZHU Huayong; ZHU Yunlin; WU Liping

Abstract：Objective:To compare clinical efficacy of imipenem prolonged infusion time(2 h)and conventional infusion (30 min)two delivery methods in treatment of acute respiratory distress syndrome(ARDS). Methods:Open clinical single -blind randomized controlled study was used. 100 ARDS patients with clinical assessment in ICU need to be given imipenem were randomly divided into two groups from August 1,2014 to August 31,2015 in Ganzhou City People’s,eliminate unqualified cases,eventually included in the study group of 38 patients in the control group of 40 patients. Study Group dosing regimen imi-penem 0. 5 g dissolved in 100 mL normal saline,intravenous infusion to maintain a constant speed infusion pump 2 h,6 h de-livery times. Control regimen imipenem 1 g dissolved in 100 mL normal saline,intravenous infusion to maintain a constant speed infusion pump 30 min,6 h delivery times. At least two groups of drug 7 d. The clinical efficacy of two groups were com-pared,bacteriological efficacy,disease severity score and the degree of improvement in drug safety and so on. Results:Com-pared with control group,the study group cure rate and 28 d survival rate was significantly higher,survival:81. 6%(31 / 38) ratio of 60. 0%(24 / 40),χ2 = 4. 364,P = 0. 037〗,clinical pulmonary infection score(CPIS)significantly improved CPIS difference(points):- 3. 47 ± 2. 48 VS - 1. 50 ± 2. 48,t = - 3. 513,P = 0. 001. Two days of imipenem treatment,acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score,procalcitonin(PCT),duration of mechanical ventilation, ICU length of stay were not statistically significant. The main side effects were observed transient elevated liver enzymes and di-arrhea,the difference of the study group and the control group was not statistically significant[elevated liver enzymes:28. 9%(11 / 38)ratio of 30. 0%(12 / 40),χ2 = 0. 010,P = 0. 919;diarrhea:7. 9%(3 / 38)ratio of 10. 0%(4 / 40),χ2 = 0. 000,P =1. 000]. Conclusion:Compared with conventional infusion methods 30 min,2 h prolonged infusion time imipenem administra-tion can improve the clinical cure rate of patients with ARDS,reducing the severity of disease and promote better organ func-tion,improve long - term prognosis.