Influence of venovenous extracorporeal membrane oxygenation on pharmacokinetics of vancomycin in lung transplant recipients.
What is known and objective: The influence of venovenous extracorporeal membrane oxygenation (VV‐ECMO) on the population pharmacokinetics (PPK) of vancomycin in recipients after lung transplantation (LTx) is unknown. We investigated whether VV‐ECMO influences vancomycin PPK and determined optimal re...
| Publicado en: | Journal of Clinical Pharmacy & Therapeutics Vol. 45; no. 5; pp. 1066 - 1076 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=145624935&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 145624935 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02694727 EV4 jtl: Journal of Clinical Pharmacy & Therapeutics issn: 02694727 maglogo: Y pubinfo: dt: Oct2020 vid: 45 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 145624935 145624935 145624935 10.1111/jcpt.13163 145624935 ppf: 1066 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Influence of venovenous extracorporeal membrane oxygenation on pharmacokinetics of vancomycin in lung transplant recipients. aug: au: Liu, Donglin Chen, Wenqian Wang, Qianlin Li, Min Zhang, Zhu Cui, Gang Li, Pengmei Zhang, Xianglin Ma, Yi Zhan, Qingyuan Wang, Chen affil: Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China‐Japan Friendship Hospital, Capital Medical University, Beijing, China sug: subj: Extracorporeal Membrane Oxygenation Vancomycin Pharmacokinetics Lung Transplantation Transplant Recipients Human Vancomycin Blood Systems Analysis Simulations Methicillin-Resistant Staphylococcus Aureus Vancomycin ab: What is known and objective: The influence of venovenous extracorporeal membrane oxygenation (VV‐ECMO) on the population pharmacokinetics (PPK) of vancomycin in recipients after lung transplantation (LTx) is unknown. We investigated whether VV‐ECMO influences vancomycin PPK and determined optimal recommended dosage for patients after LTx. Methods: We tested vancomycin serum concentration and calculated PPK parameters using NONMEM. To check for any potential influence of ECMO on vancomycin PK, we compared ECMO patients with a non‐ECMO patient control group, and patients before and after ECMO weaning as self‐control to analysed changes in vancomycin PK. Monte Carlo dosing simulation was conducted to explore vancomycin dosing regimens. Results: Nineteen ECMO and 6 non‐ECMO lung transplant recipients were enrolled. Vancomycin serum concentrations did not significantly differ between patients with and without ECMO support. Comparison of separate vancomycin population pharmacokinetic models showed that ECMO patients had smaller peripheral compartment volume of distribution (V2) [Estimate (relative standard error, RSE, %) 19.7 (12) vs. 22 (17) L, P =.003] than non‐ECMO patients. For treatment of methicillin‐resistant Staphylococcus aureus (MRSA) infections with MIC ≤ 0.5 µg/mL, venous infusion of 400 mg vancomycin every 8 hours was recommended. For MRSA infection with MIC ≤ 1 µg/mL, the proposed dosage was 600 mg every 8 hours. What is new and conclusion: Venovenous extracorporeal membrane oxygenation slightly alters vancomycin PK but does not significantly impact vancomycin serum concentration in patients after LTx. Dose adjustment is not necessary for VV‐ECMO support. Specific vancomycin dosing regimens with lower nephrotoxicity may benefit LTx recipients with VV‐ECMO. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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