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Vancomycin removal during low-flux and high-flux extended daily hemodialysis in critically ill septic patients.
MedLine Citation:
PMID:  22660225     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims. To determine the extent of vancomycin removal and vancomycin pharmacokinetics in septic patients with AKI using daily hemodialysis with polysulphone high-flux and low-flux membrane. Methods. Five patients received 6 h daily dialysis with low-flux polysulphone membrane, four patients with high-flux polysulphone membrane. Vancomycin was administered over the last hour of dialysis. The maintenance dose was adjusted based on pre-hemodialysis serum concentrations. Patients were followed up for two days. Results. Median percentage of vancomycin removal by low-flux membrane dialysis was 17% (8 - 38%) and by high-flux membrane dialysis was 31% (13-43%). Vancomycin clearance was only moderately higher in high-flux membrane dialysis (median 3.01 l/h, range 2.34-3.5 l/h) compared to low-flux dialysis (median 2.48 l/h, range 0.53-5.68 l/h) in the first day of the study. About two-fold higher vancomycin clearance in high-flux dialysis (median 3.62 l/h, range 1.37-5.07 l/h) was observed on the second day of the study than low-flux dialysis (median 1.74 l/h, range 0.75-30.94 l/h). Conclusions. Both high-flux and low-flux membrane dialysis remove considerable amounts of vancomycin in critically ill septic patients with AKI. Application of vancomycin after each dialysis was required to maintain therapeutic concentrations.
Authors:
Nadezda Petejova; Arnost Martinek; Jana Zahalkova; Jana Duricova; Hana Brozmanova; Karel Urbanek; Milan Grundmann; Ivana Kacirova
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-30
Journal Detail:
Title:  Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia     Volume:  -     ISSN:  1213-8118     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-6-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140142     Medline TA:  Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Internal Medicine, Faculty of Medicine, University of Ostrava and University Hospital Ostrava, Czech Republic. petejova@seznam.cz.
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