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Impact of CytoSorb on kinetics of vancomycin and bivalirudin in critically ill patients.
- Source :
-
Artificial organs [Artif Organs] 2021 Sep; Vol. 45 (9), pp. 1097-1103. Date of Electronic Publication: 2021 Apr 09. - Publication Year :
- 2021
-
Abstract
- CytoSorb is a promising tool to treat severe inflammatory status with multiple mechanisms in the acute care setting. Its effect on drugs is, however, poorly documented in vivo, although removal of small molecules might translate into decreased blood levels of life-saving medications. The aim of this study was to assess the impact of CytoSorb on vancomycin and bivalirudin clearance in a large population of critically ill patients. We performed a single-center analysis of CytoSorb treatments performed between January 2018 and March 2019 in critically ill patients admitted to our intensive care unit. A total of 109 CytoSorb treatments were performed in 89 patients. A decrease in lactate dehydrogenase (P = .007), troponin T (P = .022), and creatine phosphokinase (P = .013) was reported during treatment. Vancomycin dose required significant adjustments during treatment (P < .001), but no significant change was necessary after the first 3 days. Similarly, the requirements of bivalirudin significantly changed over days (P < .001), but no dose adjustment was needed after the first 3 days of treatment. No differences in terms of vancomycin and bivalirudin dose need was observed between patients on extracorporeal membrane oxygenation and those who were not (P = .6 and P = .6, respectively), between patients with and without continuous veno-venous hemofiltration (P = .9 and P = .9, respectively), and between CytoSorb responders or not (P = .4 and P = .7, respectively). CytoSorb is effective in mitigating the systemic inflammatory response and safe with respect to vancomycin and bivalirudin administration. These preliminary data further support the use of CytoSorb as adjunct therapy in critically ill patients.<br /> (© 2021 International Center for Artificial Organs and Transplantation and Wiley Periodicals LLC.)
- Subjects :
- Anti-Bacterial Agents administration & dosage
Antithrombins administration & dosage
Biomarkers blood
Extracorporeal Membrane Oxygenation
Female
Hirudins administration & dosage
Humans
Infusions, Intravenous
Intensive Care Units
Male
Middle Aged
Peptide Fragments administration & dosage
Recombinant Proteins administration & dosage
Recombinant Proteins pharmacokinetics
Retrospective Studies
Vancomycin administration & dosage
Anti-Bacterial Agents pharmacokinetics
Antithrombins pharmacokinetics
Critical Illness
Hemadsorption
Hirudins pharmacokinetics
Peptide Fragments pharmacokinetics
Vancomycin pharmacokinetics
Subjects
Details
- Language :
- English
- ISSN :
- 1525-1594
- Volume :
- 45
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Artificial organs
- Publication Type :
- Academic Journal
- Accession number :
- 33686696
- Full Text :
- https://doi.org/10.1111/aor.13952