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Commentary

Identifying patients at risk for augmented renal clearance in the ICU - limitations and challenges

Mieke Carlier12 and Jan J De Waele1*

Author Affiliations

1 Department of Critical Care Medicine, Ghent University Hospital, Ghent, 9000 Belgium

2 Department of Clinical Chemistry, Immunology and Microbiology, Ghent University Hospital, Ghent, 9000 Belgium

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Critical Care 2013, 17:130  doi:10.1186/cc12573


See related research by Udy et al., http://ccforum.com/content/17/1/R35

Published: 16 April 2013

Abstract

Augmented renal clearance (ARC) is an important determinant of antibiotic exposure in critically ill patients, and identifying patients at risk is therefore an important goal. There is a growing body of evidence that a younger patient with a low to moderate degree of organ dysfunction typically is at risk of ARC and therefore decreased exposure to renally eliminated antibiotics. Mechanisms potentially involved, such as increased cardiac output, have, however, not been identified as appropriate surrogate markers, and the search for suitable alternatives to readily identify patients with ARC continues.