정태석 연구실은 뇌외상과 척추외상을 중심으로 한 신경손상외과 연구를 수행하며, 외상 환자의 진단과 수술적 치료, 정밀 방사선치료 계획, 그리고 인공지능 기반 의료영상 분석 기술을 아우르는 임상 융합 연구를 통해 중증 신경계 손상의 치료 정확도와 예후 개선에 기여하고 있다.
Author Correction: Evaluation of U-Net models in automated cervical spine and cranial bone segmentation using X-ray images for traumatic atlanto-occipital dislocation diagnosis
Jaehyuk Shim, Woo Seok Kim, Kwang Gi Kim, Gi Taek Yee, Young Jae Kim, Tae Seok Jeong
Single-Center Pharmacokinetic Study and Simulation of a Low Meropenem Concentration in Brain-Dead Organ Donors
Jae Myeong Lee, Joo Won Lee, Tae Seok Jeong, Eun Sook Bang, So Hee Kim
IF 4.5
Antimicrobial Agents and Chemotherapy
Meropenem is an ultrabroad-spectrum antibiotic of the carbapenem family. In brain-dead organ donors, administration of standard meropenem dosages does not reach therapeutic levels. Our objectives were to determine the plasma concentration of meropenem after the administration of standard meropenem dose and to estimate an improved dosage regimen for these patients. One gram of meropenem was administered as a 1-h infusion every 8 h for 1 to 3 days, and blood samples were collected. The plasma concentration of meropenem was measured and subjected to pharmacokinetic analysis. Simcyp simulation was performed to predict the optimum plasma levels and dosage based on the patients' individual pharmacokinetic parameters. The maximum plasma concentration of meropenem was 3.29 μg/ml, which was lower than four times the MIC of 8 μg/ml. Although the mean creatinine clearance of patients was moderately low (67.5 ml/min), the apparent volume of distribution at steady state (<i>V</i><sub>ss</sub>) and time-averaged total body clearance (CL) of meropenem were markedly elevated (4.97 liters/kg and 2.06 liters/h/kg, respectively), owing to massive fluid loading to decrease the high sodium levels and to treat shock or dehydration. The simulation revealed that dose and infusion time of meropenem should be increased based on patients' <i>V</i><sub>ss</sub> and CL, and a loading dose is recommended to reach rapidly the target concentration. In conclusion, a standard meropenem regimen is insufficient to achieve optimal drug levels in brain-dead patients, and an increase in dose and extended or continuous infusion with intravenous bolus administration of a loading dose are recommended for these patients.