{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T18:40:05Z","timestamp":1748025605669,"version":"3.41.0"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"To explore the risk factors influencing vancomycin trough concentration (C<\/mml:mi>v<\/mml:mi>g<\/mml:mi>\u2212<\/mml:mo>m<\/mml:mi>i<\/mml:mi>n<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math><\/jats:alternatives><\/jats:inline-formula>) overexposure in critically ill patients with mechanical ventilation and rank the factors, the medical records of 194 mechanically ventilated critically ill patients hospitalized from 12\/10\/2021\u201306\/10\/2024 were analyzed. Among 194 critically ill patients, 77.83% were male and 22.17% were female. Univariate analysis showed that oxygenation index (OI), activated partial thromboplastin time (APTT), urea nitrogen (UN), septic shock, heart disease, congestive heart failure (CHF), moderate\/severe chronic kidney disease (CKD), etc. were statistically different (P<\/jats:italic>\u2009<\u20090.05). And APTT, OI, CHF and moderate\/severe CKD were statistically different in multivariate logistic regression (P<\/jats:italic>\u2009<\u20090.05). The receiver operating characteristic (ROC) curve constructed for APTT and OI was 0.7779 (95% CI [0.708,0.848], P<\/jats:italic>\u2009<\u20090.001), with a sensitivity and specificity were 72.99% and 71.93%, respectively. The consistency index (CI<\/jats:italic>) and consistency ratio (CR<\/jats:italic>) of analytic hierarchy process (AHP) was 0.0796 and 0.0885, respectively, which meets the consistency test standard. The contributions of APTT, OI, CHF and moderate to severe CKD to the overexposure of C<\/mml:mi>v<\/mml:mi>g<\/mml:mi>\u2212<\/mml:mo>m<\/mml:mi>i<\/mml:mi>n<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math><\/jats:alternatives><\/jats:inline-formula> were 0.0584, 0.1899, 0.1614 and 0.5902, respectively. The overexposure rates of C<\/mml:mi>v<\/mml:mi>g<\/mml:mi>\u2212<\/mml:mo>m<\/mml:mi>i<\/mml:mi>n<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math><\/jats:alternatives><\/jats:inline-formula> in patients with moderate\/severe CKD and CHF were 95.12% and 95.23%, respectively. With regard to OI, when the cutoff value of OI was less than 245, the C<\/mml:mi>v<\/mml:mi>g<\/mml:mi>\u2212<\/mml:mo>m<\/mml:mi>i<\/mml:mi>n<\/mml:mi><\/mml:mrow><\/mml:msub>\u00a0<\/mml:mtext><\/mml:mrow><\/mml:math><\/jats:alternatives><\/jats:inline-formula>overexposure rate was 83%, otherwise, the overexposure rate was 60.97%. The risk factors for excessive exposure of C<\/mml:mi>v<\/mml:mi>g<\/mml:mi>\u2212<\/mml:mo>m<\/mml:mi>i<\/mml:mi>n<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:mrow><\/mml:math><\/jats:alternatives><\/jats:inline-formula> in critically ill patients with mechanical ventilation were ranked as follows: moderate\/severe CKD\u2009>\u2009OI\u2009>\u2009CHF\u2009>\u2009APTT.<\/jats:p>","DOI":"10.1371\/journal.pone.0324510","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T18:01:08Z","timestamp":1748023268000},"page":"e0324510","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identification of risk factors for supra-therapeutic vancomycin trough levels in ventilator-assisted critical care patients based on integrated modeling and multi-criteria decision analysis"],"prefix":"10.1371","volume":"20","author":[{"given":"Xi","family":"Cao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bi-ting","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cai-peng","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing-yue","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ding-guo","family":"Dong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miao-ting","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-zhao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3193-8950","authenticated-orcid":true,"given":"Yong-chun","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"issue":"1","key":"pone.0324510.ref001","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1007\/s13318-021-00730-z","article-title":"Pharmacokinetics 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