|Research Article:||The effect of direct hemoperfusion with polymyxin B immobilized cartridge on meropenem in critically ill patients requiring renal support|
|Author:||Asst. Prof. Dr. Weerachai Chaijamorn|
|Faculty:||Faculty of Pharmacy, Siam University, Bangkok Thailand 10160|
|Published:||Journal of Critical Care, 2019-06-01, Volume 51, Pages 71-76 PubMed PMID: 30769293 doi: 10.1016/j.jcrc.2019.02.007|
Wanchana 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.
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