Pharmacokinetics of vancomycin in adults receiving extracorporeal membrane oxygenation
Journal
Journal of the Formosan Medical Association
Journal Volume
115
Journal Issue
7
Pages
560
Date Issued
2016-07-01
Author(s)
Abstract
Background/purpose: Extracorporeal membrane oxygenation (ECMO) alters the pharmacokinetics (PK) of vancomycin in neonates; but data on adults is limited. Methods: This is a prospective, matched cohort, single center, pharmacokinetic study. For each adult patient who received vancomycin therapy in the ECMO group (with either centrifugal pump or roller pump), a control patient was matched by age (? 60 years or < 60 years), gender, and creatinine clearance (CLCr) in intensive care units. After vancomycin was administered for at least four doses, serial blood samples were drawn at 0.5 hours, 1 hour, 2 hours, 3 hours, 5 hours, 7 hours, 11 hours, 23 hours, 35 hours, and 47 hours post vancomycin infusion according to the dosing intervals. The serum concentration-time profile was fitted to a noncompartment model and a nonlinear mixed effect model to determine the PK parameters. Results: Twenty-two critically ill adults without renal replacement therapy were enrolled. There were no significant differences between the ECMO group and the matched group in demographics, renal function, and PK parameters. However, vancomycin clearance in the roller pump group was significantly lower than that in the matched control (0.83 ± 0.43 mL/min/kg vs. 0.97 ± 0.43 mL/min/kg, p = 0.002). Conclusion: Vancomycin clearance in patients receiving ECMO with a roller pump was significantly lower than that in the matched cohort. Vancomycin PK parameters in patients on ECMO with a centrifugal pump were comparable to those in the matched control group. ? 2015 Formosan Medical Association. Published by Elsevier Taiwan LLC.
SDGs
Other Subjects
silicone; vancomycin; antiinfective agent; vancomycin; adult; aged; Article; blood pump; blood sampling; central venous catheter; centrifugal pump; clinical article; clinical trial; controlled study; creatinine clearance; critically ill patient; extracorporeal oxygenation; female; hollow fiber; human; infusion; intensive care; kidney function; membrane oxygenator; methicillin resistant Staphylococcus aureus infection; nonhuman; roller pump; adolescent; controlled clinical trial; critical illness; drug monitoring; male; middle aged; prospective study; statistical model; Taiwan; young adult; Adolescent; Adult; Aged; Anti-Bacterial Agents; Critical Care; Critical Illness; Drug Monitoring; Extracorporeal Membrane Oxygenation; Female; Humans; Linear Models; Male; Middle Aged; Prospective Studies; Taiwan; Vancomycin; Young Adult
Type
journal article