The effect of direct hemoperfusion with polymyxin B immobilized cartridge on meropenem in critically ill patients requiring renal support

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Research Article: The effect of direct hemoperfusion with polymyxin B immobilized cartridge on meropenem in critically ill patients requiring renal support
ผู้เขียน/Author: ผศ.ดร.วีรชัย ไชยจามร / Asst.Prof.Dr.Weerachai Chaijamorn
Email: weerachai.cha@siam.edu
คณะ/สาขาวิชา: คณะเภสัชศาสตร์ มหาวิทยาลัยสยาม กรุงเทพ 10160
Department Faculty of Pharmacy, Siam University, Bangkok Thailand 10160
Published/แหล่งเผยแพร่ PubMed PMID: 30769293 doi: 10.1016/j.jcrc.2019.02.007 /Journal of Critical Care, 2019-06-01, Volume 51, Pages 71-76

Reference

Journal of Critical Care-vol50-april2019Wanchana Singhan, Somratai Vadcharavivad, Nutthada Areepium, Supeecha Wittayalertpanya, Weerachai Chaijamorn, and Nattachai Srisawat. (2019). The effect of direct hemoperfusion with polymyxin B immobilized cartridge on meropenem in critically ill patients requiring renal support. Journal of Critical Care, 51, 71-76. doi:10.1016/j.jcrc.2019.02.007.


 

ABSTRACT

Purpose:  To evaluate the effect of direct hemoperfusion with polymyxin B immobilized cartridge (DHP-PMX) on meropenem pharmacokinetics in critically ill patients with sepsis requiring continuous venovenous hemofiltration (CVVH).

Material and methods:  After intravenous infusion of 1 g meropenem over 3 h repeated every 8 h for at least 3 doses, 2 serial blood and ultrafiltration fluid samples were collected: one over a dose interval of meropenem with DHP-PMX therapy; and the other on the following day over a dose interval of meropenem with no DHP-PMX therapy. Meropenem concentrations were measured by high-performance liquid chromatography. Pharmacokinetic parameters of meropenem and extraction ratio of DHP-PMX were calculated.

Results:  Mean AUC0-8 of meropenem on DHP-PMX day was comparable to that of the DHP-PMX free day (285.2 ± 138.2 vs 297.8 ± 130.2 mg ∗ h/L; paired t-test, p = .618). No statistical significance of peak and trough concentrations, the volume of distribution, sieving coefficient, or half-life was found. Extraction ratio of DHP-PMX on meropenem was 0 [0-0.03] and clearance by DHP-PMX was 0.04 [0-0.2] L/h which was not considered clinically significant.

Conclusions: No significant effect of DHP-PMX on meropenem pharmacokinetics was observed among severe sepsis/septic shock patients during CVVH treatment.

Keywords: Continuous venovenous hemofiltration, Hemoperfusion, Meropenem, Polymyxin B immobilized cartridge.


The effect of direct hemoperfusion with polymyxin B immobilized cartridge on meropenem in critically ill patients requiring renal support

Faculty of Pharmacy, Siam University, Bangkok, Thailand

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