1. Vancomycin population pharmacokinetics during extracorporeal membrane oxygenation therapy: a matched cohort study
- Author
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Frédérique Jacobs, Jean Louis Vincent, Fabio Silvio Taccone, Stefano Cristallini, Jason A. Roberts, Daniel De Backer, Katia Donadello, Asmae Belhaj, Kiran Shekar, Marjorie Beumier, UCL - (MGD) Service de chirurgie cardio-vasculaire et thoracique, and UCL - SSS/IREC/MONT - Pôle Mont Godinne
- Subjects
Adult ,medicine.medical_specialty ,Metabolic Clearance Rate ,Critical Illness ,medicine.medical_treatment ,Renal function ,Critical Care and Intensive Care Medicine ,Loading dose ,Cohort Studies ,Young Adult ,03 medical and health sciences ,Extracorporeal Membrane Oxygenation ,0302 clinical medicine ,Pharmacokinetics ,Vancomycin ,Interquartile range ,medicine ,Extracorporeal membrane oxygenation ,Humans ,030212 general & internal medicine ,Retrospective Studies ,Anti-Bacterial Agents ,Middle Aged ,Volume of distribution ,0303 health sciences ,030306 microbiology ,business.industry ,Research ,Généralités ,Retrospective cohort study ,3. Good health ,Surgery ,surgical procedures, operative ,Anesthesia ,business ,medicine.drug - Abstract
Introduction: The aim of this study was to describe the population pharmacokinetics of vancomycin in critically ill patients treated with and without extracorporeal membrane oxygenation (ECMO).Methods: We retrospectively reviewed data from critically ill patients treated with ECMO and matched controls who received a continuous infusion of vancomycin (35 mg/kg loading dose over 4 hours followed by a daily infusion adapted to creatinine clearance, CrCl)). The pharmacokinetics of vancomycin were described using non-linear mixed effects modeling.Results: We compared 11 patients treated with ECMO with 11 well-matched controls. Drug dosing was similar between groups. The median interquartile range (IQR) vancomycin concentrations in ECMO and non-ECMO patients were 51 (28 to 71) versus 45 (37 to 71) mg/L at 4 hours; 23 (16 to 38) versus 29 (21 to 35) mg/L at 12 hours; 20 (12 to 36) versus 23 (17-28) mg/L at 24 hours (ANOVA, P =0.53). Median (ranges) volume of distribution (Vd) was 99.3 (49.1 to 212.3) and 92.3 (22.4 to 149.4) L in ECMO and non-ECMO patients, respectively, and clearance 2.4 (1.7 to 4.9) versus 2.3 (1.8 to 3.6) L/h (not significant). Insufficient drug concentrations (that is drug levels 2 of 0.67; P, SCOPUS: ar.j, info:eu-repo/semantics/published
- Published
- 2014
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