Pharmacokinetics of cefpirome during continuous venovenous hemofiltration: Rationale for an 8-hour dosing interval

2000 ◽  
Vol 67 (4) ◽  
pp. 368-372 ◽  
Author(s):  
M Banyai
Keyword(s):  
Continuous Venovenous Hemofiltration ◽  
Dosing Interval

scholarly journals Pharmacokinetics and Pharmacodynamics of Imipenem during Continuous Renal Replacement Therapy in Critically Ill Patients

2005 ◽  
Vol 49 (6) ◽  
pp. 2421-2428 ◽  
Author(s):  
Douglas N. Fish ◽  
Isaac Teitelbaum ◽  
Edward Abraham
Keyword(s):  
High Performance ◽  
Continuous Venovenous Hemofiltration ◽  
Systemic Clearance ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Drug Infusion ◽  
Dosing Interval ◽  
Adult Intensive Care Unit ◽  
Drug Concentrations ◽  
Elimination Half ◽  
Higher Doses

ABSTRACT The pharmacokinetics of imipenem were studied in adult intensive care unit (ICU) patients during continuous venovenous hemofiltration (CVVH; n = 6 patients) or hemodiafiltration (CVVHDF; n = 6 patients). Patients (mean ± standard deviation age, 50.9 ± 15.9 years; weight, 98.5 ± 15.9 kg) received imipenem at 0.5 g every 8 to 12 h (total daily doses of 1 to 1.5 g/day) by intravenous infusion over 30 min. Pre- and postmembrane blood (plasma) and corresponding ultrafiltrate or dialysate samples were collected 1, 2, 4, and 8 or 12 h (depending on dosing interval) after completion of the drug infusion. Drug concentrations were measured using validated high-performance liquid chromatography methods. Mean systemic clearance (CL S ) and elimination half-life (t 1/2) of imipenem were 145 ± 18 ml/min and 2.7 ± 1.3 h during CVVH versus 178 ± 18 ml/min and 2.6 ± 1.6 h during CVVHDF, respectively. Imipenem clearance was substantially increased during both CVVH and CVVHDF, with membrane clearance representing 25% and 32% of CL S , respectively. The results of this study indicate that CVVH and CVVHDF contribute to imipenem clearance to a greater degree than previously reported. Imipenem doses of 1.0 g/day appear to achieve concentrations adequate to treat most common gram-negative pathogens (MIC up to 2 μg/ml) during CVVH or CVVHDF, but doses of 2.0 g/day or more may be required to adequately treat and prevent resistance in pathogens with higher MICs (MIC = 4 to 8 μg/ml). Higher doses should only be used after consideration of potential central nervous system toxicities or other risks of therapy in these severely ill patients.

scholarly journals Ceftolozane-Tazobactam Pharmacokinetics in a Critically Ill Patient on Continuous Venovenous Hemofiltration

2015 ◽  
Vol 60 (3) ◽  
pp. 1899-1901 ◽  
Author(s):  
Wesley D. Oliver ◽  
Emily L. Heil ◽  
Jeffrey P. Gonzales ◽  
Shailly Mehrotra ◽  
Kathryn Robinett ◽  
...  
Keyword(s):  
Critically Ill ◽  
Multidrug Resistant ◽  
Critically Ill Patient ◽  
Continuous Venovenous Hemofiltration ◽  
Time Curve ◽  
Content Type ◽  
Dosing Interval ◽  
Drug Concentrations ◽  
Extended Infusion ◽  
Susceptibility Breakpoint

Extended-infusion ceftolozane-tazobactam treatment at 1.5 g every 8 h was used to treat multidrug-resistantPseudomonas aeruginosain a critically ill patient on continuous venovenous hemofiltration. Serum drug concentrations were measured at 1, 4, 5, 6, and 8 h after the start of infusion. Prefilter levels of ceftolozane produced a maximum concentration of drug (Cmax) of 38.57 μg/ml, concentration at the end of the dosing interval (Cmin) of 31.63 μg/ml, time toCmax(Tmax) of 4 h, area under the concentration-time curve from 0 to 8 h (AUC0–8) of 284.38 μg · h/ml, and a half-life (t1/2) of 30.7 h. The concentrations were eight times the susceptibility breakpoint for the entire dosing interval.

Treatment of hyperammonemia using in-line renal replacement and hyperosmolar therapies within an extracorporeal membrane oxygenation circuit

Perfusion ◽  
2021 ◽  
pp. 026765912110359
Author(s):  
Alison Grazioli ◽  
Jamie E Podell ◽  
Aldo Iacono ◽  
Alexander Sasha Krupnik ◽  
Ronson J Madathil ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Cerebral Edema ◽  
Urea Cycle ◽  
Rare Complication ◽  
Volume Of Distribution ◽  
Intermittent Hemodialysis ◽  
Treatment Goals ◽  
Continuous Venovenous Hemofiltration ◽  
Small Molecular Weight ◽  
Membrane Oxygenation

After orthotopic lung transplantation, hyperammonemia can be a rare complication secondary to infection by organisms that produce urease or inhibit the urea cycle. This can cause neurotoxicity, cerebral edema, and seizures. Ammonia is unique in that it has a large volume of distribution. However, it is also readily dialyzable given its small molecular weight. As such, removal of ammonia requires renal replacement modalities that can both rapidly remove ammonia from the plasma space and allow for continuous removal to prevent rebound accumulation from intracellular stores. Prevention of iatrogenic osmotic lowering in this setting is required to prevent worsening of cerebral edema. Herein, we describe use of sequential in-line renal replacement therapy using both intermittent hemodialysis and continuous venovenous hemofiltration within an extracorporeal membrane oxygenation circuit in conjunction with higher sodium dialysate and 7.5% hypertonic saline to achieve these treatment goals.

scholarly journals Once-Daily Amikacin Dosing in Burn Patients Treated with Continuous Venovenous Hemofiltration

2011 ◽  
Vol 55 (10) ◽  
pp. 4639-4642 ◽  
Author(s):  
Kevin S. Akers ◽  
Jason M. Cota ◽  
Christopher R. Frei ◽  
Kevin K. Chung ◽  
Katrin Mende ◽  
...  
Keyword(s):  
Burn Injury ◽  
Continuous Venovenous Hemofiltration ◽  
Burn Patients ◽  
Small Reduction ◽  
Target Attainment ◽  
Clinical Pharmacokinetics ◽  
Once Daily ◽  
Renal Replacement Therapies ◽  
Rapid Clearance ◽  
The Impact

ABSTRACTAmikacin clearance can be increased in burn injury, which is often complicated by renal insufficiency. Little is known about the impact of renal replacement therapies, such as continuous venovenous hemofiltration (CVVH), on amikacin pharmacokinetics. We retrospectively examined the clinical pharmacokinetics, bacteriology, and clinical outcomes of 60 burn patients given 15 mg/kg of body weight of amikacin in single daily doses. Twelve were treated with concurrent CVVH therapy, and 48 were not. The pharmacodynamic target of ≥10 for the maximum concentration of drug in serum divided by the MIC (Cmax/MIC) was achieved in only 8.5% of patients, with a small reduction ofCmaxin patients receiving CVVH and no difference in amikacin clearance. Mortality and burn size were greater in patients who received CVVH. Overall, 172 Gram-negative isolates were recovered from the blood cultures of 39 patients, with amikacin MIC data available for 82 isolates from 24 patients. A 10,000-patient Monte Carlo simulation was conducted incorporating pharmacokinetic and MIC data from these patients. The cumulative fraction of response (CFR) was similar in CVVH and non-CVVH patients. The CFR rates were not significantly improved by a theoretical 20 mg/kg amikacin dose. Overall, CVVH did not appear to have a major impact on amikacin serum concentrations. The low pharmacodynamic target attainment appears to be primarily due to higher amikacin MICs rather than more rapid clearance of amikacin related to CVVH therapy.

Plasmapheresis combined with continuous venovenous hemofiltration in surgical patients with sepsis

2000 ◽  
Vol 26 (5) ◽  
pp. 532-537 ◽  
Author(s):  
J. Schmidt ◽  
S. Mann ◽  
V. D. Mohr ◽  
R. Lampert ◽  
U. Firla ◽  
...  
Keyword(s):  
Surgical Patients ◽  
Continuous Venovenous Hemofiltration

Lacosamide Pharmacokinetics in a Critically Ill Patient Receiving Continuous Venovenous Hemofiltration

2017 ◽  
Vol 38 (2) ◽  
pp. e17-e21 ◽  
Author(s):  
Miguel J. Franquiz ◽  
Shamir N. Kalaria ◽  
Michael J. Armahizer ◽  
Mathangi Gopalakrishnan ◽  
Paul J. McCarthy ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patient ◽  
Continuous Venovenous Hemofiltration

Pharmacokinetic Evaluation of Voriconazole Treatment in Critically Ill Patients Undergoing Continuous Venovenous Hemofiltration

2011 ◽  
Vol 33 (4) ◽  
pp. 393-397 ◽  
Author(s):  
Jaroslav Radej ◽  
Ales Krouzecky ◽  
Pavel Stehlik ◽  
Roman Sykora ◽  
Jiri Chvojka ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Continuous Venovenous Hemofiltration ◽  
Pharmacokinetic Evaluation
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