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<p>Bonjour,</p>
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<p>Pour les antibiotiques , on a tendance parfois à négliger leur posologie par poids du patient. Le GPR recommande : une dose de charge initiale de 30 mg/kg et un entretien 10 mg/kg toutes les 48h avec un Tx résiduel à 10 - 20 mg/l.<br>
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<p>Bien à vous.<br>
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<p>Dr Boukelmoune.<br>
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<p>CH de Toulon<br>
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<div id="divRplyFwdMsg" dir="ltr"><font face="Calibri, sans-serif" color="#000000" style="font-size:11pt"><b>De :</b> Renaliste <renaliste-bounces@nephrodial.org> de la part de Amar AMAOUCHE <aamaouche@aurar.fr><br>
<b>Envoyé :</b> mardi 2 février 2016 14:30<br>
<b>À :</b> 'Liste des néphrologues francophones'<br>
<b>Objet :</b> Re: [Renaliste] Administration de la Vancomycine en hémodialyse et protocole d'anticoagulation chez le patient hémodialysé</font>
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<p class="MsoNormal"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">Bonjour</span></font></p>
<p class="MsoNormal"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy"> </span></font></p>
<p class="MsoNormal"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">Pour la Vanco plutôt 1g/30mn après la séance de dialyse(reco. d’ICAR)</span></font></p>
<p class="MsoNormal"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy"> </span></font></p>
<p class="MsoNormal"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">Pour l’heparine 25u/kg en dose de charge (bolus) puis 15 u/kg en entretien avec arret 30mn avant la fin de la séance
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<p class="MsoNormal"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy"> </span></font></p>
<p class="MsoNormal"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">Cordialement
</span></font></p>
<p class="MsoNormal"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">Amar Amaouche</span></font></p>
<p class="MsoNormal"><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">Saint pierre</span></font></p>
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<p><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">_______________________________</span></font><font color="navy"><span style="color:navy">
<br>
</span></font><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">Dr Amar AMAOUCHE</span></font><font color="navy"><span style="color:navy">
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</span></font><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">AURAR PNS 1</span></font><font color="navy"><span style="color:navy">
<br>
</span></font><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">15 rue des Roches</span></font><font color="navy"><span style="color:navy">
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</span></font><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">97410 SAINT PIERRE</span></font><font color="navy"><span style="color:navy">
<br>
</span></font><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">Tél. 0262 54 99 40</span></font><font color="navy"><span style="color:navy">
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</span></font><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">Fax 0262 54 99 38</span></font><font color="navy"><span style="color:navy">
<br>
</span></font><font size="2" color="navy" face="Arial"><span style="font-size:10.0pt; font-family:Arial; color:navy">Portable : 0692 23 84 91</span></font><font color="navy"><span style="color:navy">
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<p class="MsoNormal"><b><font size="2" face="Tahoma"><span style="font-size:10.0pt; font-family:Tahoma; font-weight:bold">De :</span></font></b><font size="2" face="Tahoma"><span style="font-size:10.0pt; font-family:Tahoma"> Renaliste [mailto:renaliste-bounces@nephrodial.org]
<b><span style="font-weight:bold">De la part de</span></b> seigneuric.b@chu-toulouse.fr<br>
<b><span style="font-weight:bold">Envoyé :</span></b> mardi 2 février 2016 15:46<br>
<b><span style="font-weight:bold">À :</span></b> coulibaly1981@yahoo.fr; renaliste@nephrodial.org<br>
<b><span style="font-weight:bold">Objet :</span></b> Re: [Renaliste] Administration de la Vancomycine en hémodialyse et protocole d'anticoagulation chez le patient hémodialysé</span></font></p>
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<p class="MsoNormal"><font size="3" face="Times New Roman"><span style="font-size:12.0pt"> </span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D">Bonjour,</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D"> </span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D">Concernant la vancomycine nous l’administrons à 1 g/H ; si la dose à administrer est supérieure à 1 g on prolonge sur 1H30
voire 2H en deuxième partie de séance.</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D">Concernant l’HNF nous commençons par :</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D">- une dose de charge au branchement : ½ mg/Kg avec 10 mg = 1000U soit 3000 U pour un sujet de 60Kg, puis
</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D">- une dose d’entretien de 333 à 666 U/ H d’héparine sur 3H30 lors d’une dialyse de 4H sur FAV et sur toute la séance pour un
cathéter. On ne dépasse pas 999U/H.</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D">On adapte secondairement les doses en fonction de l’état du rein et du patient.</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D">Avec les bains au citrate la dose d’héparine a pu être baissée.</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D"> </span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D">Cordialement</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D"> </span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D"> </span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size:10.0pt; color:#1F497D">Dr B. Seigneuric</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size:10.0pt; color:#1F497D">Praticien Hospitalier</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size:10.0pt; color:#1F497D">Département de Néphrologie, Dialyse et Transplantation d’Organes - Unité de Dialyse Périodique</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size:10.0pt; color:#1F497D">CHU Rangueil – Larrey</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size:10.0pt; color:#1F497D">31059 Toulouse Cedex 9</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size:10.0pt; color:#1F497D">Tel 05 67 77 18 90</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Times New Roman"><span style="font-size:10.0pt; color:#1F497D">Fax 05 67 77 18 88</span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D"> </span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D"> </span></font></p>
<p class="MsoNormal"><font size="2" color="#1f497d" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; color:#1F497D"> </span></font></p>
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<p class="MsoNormal"><b><font size="2" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri; font-weight:bold">De :</span></font></b><font size="2" face="Calibri"><span style="font-size:11.0pt; font-family:Calibri"> Renaliste [mailto:renaliste-bounces@nephrodial.org]
<b><span style="font-weight:bold">De la part de</span></b> moussa coulibaly<br>
<b><span style="font-weight:bold">Envoyé :</span></b> mardi 2 février 2016 11:16<br>
<b><span style="font-weight:bold">À :</span></b> Liste des néphrologues francophones<br>
<b><span style="font-weight:bold">Objet :</span></b> [Renaliste] Administration de la Vancomycine en hémodialyse et protocole d'anticoagulation chez le patient hémodialysé</span></font></p>
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<div id="yui_3_16_0_1_1454407169002_5400">
<p class="MsoNormal" style="background:white"><font size="1" color="black" face="Helvetica"><span style="font-size:9.0pt; font-family:Helvetica; color:black">Bonjour,</span></font></p>
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<p class="MsoNormal" style="background:white"><font size="1" color="black" face="Helvetica"><span style="font-size:9.0pt; font-family:Helvetica; color:black"> </span></font></p>
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<div id="yui_3_16_0_1_1454407169002_5380">
<p class="MsoNormal" style="background:white"><font size="1" color="black" face="Helvetica"><span style="font-size:9.0pt; font-family:Helvetica; color:black">J'ai deux questions concernant l'administration de la vancomycine chez le patient hémodialysé et l'héparine
en continue chez les patients hémodialysés </span></font></p>
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<div id="yui_3_16_0_1_1454407169002_5379">
<p class="MsoNormal" style="background:white"><font size="1" color="black" face="Helvetica"><span style="font-size:9.0pt; font-family:Helvetica; color:black">qui ont un risque hémorragique et de coagulation du circuit.
</span></font></p>
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<div id="yui_3_16_0_1_1454407169002_5417">
<p class="MsoNormal" style="background:white"><font size="1" color="black" face="Helvetica"><span style="font-size:9.0pt; font-family:Helvetica; color:black">J'ai eu toujours l'habitude d'administrer la Vancomycine sur la dernière heure de dialyse. Avez vous
d'autres habitudes?</span></font></p>
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<div id="yui_3_16_0_1_1454407169002_5378">
<p class="MsoNormal" style="background:white"><font size="1" color="black" face="Helvetica"><span style="font-size:9.0pt; font-family:Helvetica; color:black">Concernant l'héparine, j'applique le protocole suivant : 25 UI/kg/h la première heure de dialyse puis
12.5 UI/kg/h la 2ème et 3ème heure de dialyse puis j'arrête la dernière heure de dialyse. Avez vous d'autres façons de faire en dehors de l'utilisation des membranes héparinées.</span></font></p>
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<p class="MsoNormal" style="background:white"><font size="1" color="black" face="Helvetica"><span style="font-size:9.0pt; font-family:Helvetica; color:black"> </span></font></p>
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<div id="yui_3_16_0_1_1454407169002_5452">
<p class="MsoNormal" style="background:white"><font size="1" color="black" face="Helvetica"><span style="font-size:9.0pt; font-family:Helvetica; color:black">Merci</span></font></p>
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<p class="MsoNormal" style="background:white"><font size="1" color="black" face="Helvetica"><span style="font-size:9.0pt; font-family:Helvetica; color:black"> </span></font></p>
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<p class="MsoNormal" style="background:white"><font size="1" color="black" face="Helvetica"><span style="font-size:9.0pt; font-family:Helvetica; color:black">Dr COULIBALY Moussa</span></font></p>
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<p class="MsoNormal" style="background:white"><font size="1" color="black" face="Helvetica"><span style="font-size:9.0pt; font-family:Helvetica; color:black">Centre Hospitalier d'Agen</span></font></p>
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