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Augmented renal clearance

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https://www.readbyqxmd.com/read/29124988/extracorporeal-elimination-of-butalbital-in-acute-aspirin-butalbital-caffeine-codeine-fiorinal-with-codeine-poisoning
#1
Janelle O Poyant, Robert Albright, Jeremy Clain, Govind Pandompatam, Erin F Barreto
BACKGROUND: Butalbital is a small molecule (approximately 220 Da), with 26% protein binding, a 0.8 L/kg volume of distribution, and is eliminated nearly 80% unchanged in the urine. Although hemodialysis has been used to treat overdoses of other barbiturates, the extracorporeal clearance of butalbital is unknown. The objective of this case is to describe the use of extracorporeal therapy to augment elimination of butalbital after an overdose of aspirin 325 mg-butalbital 50 mg-caffeine 40 mg with codeine 30 mg (Fiorinal with Codeine)...
November 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29097070/characterization-of-variables-for-potential-impact-on-vancomycin-pharmacokinetics-in-thermal-or-inhalation-injury
#2
Katie Elder, David M Hill, William L Hickerson
OBJECTIVE: To characterize the pharmacokinetics of vancomycin dosing in thermal or inhalation injury as they relate to percent total body surface area burn (TBSA) and days since injury (DSI). METHODS: This retrospective 3-year study included patients with thermal or inhalation injury receiving vancomycin. Patient demographics and course data were collected using the institution's electronic medical record. RESULTS: Six hundred and fifty-four patients were included in the study; 124 remained after exclusion...
October 30, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29096171/considerations-for-effect-site-pharmacokinetics-to-estimate-drug-exposure-concentrations-of-antibiotics-in-the-lung
#3
REVIEW
Keith A Rodvold, William W Hope, Sara E Boyd
Bronchoalveolar lavage (BAL) and microdialysis have become the most reliable and relevant methods for measuring lung concentrations of antibiotics, with the majority of BAL studies involving either healthy adult subjects or patients undergoing diagnostic bronchoscopy. Emphasis on the amount of drug that reaches the site of infection is increasingly recognized as necessary to determine whether a dose selection will translate to good clinical outcomes in the treatment of patients with pneumonia. Observed concentrations and/or parameters of exposure (e...
October 30, 2017: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29091209/determination-of-alternative-ceftolozane-tazobactam-dosing-regimens-for-patients-with-infections-due-to-pseudomonas-aeruginosa-with-mic-values-between-4-and-32%C3%A2-mg-l
#4
Senthil Natesan, Manjunath P Pai, Thomas P Lodise
Background: Optimization of the antibiotics for patients with infections due to MDR Pseudomonas aeruginosa (MDR-PA) often requires consideration of alternate dose and infusion times that can be influenced by renal function. Objectives: We sought to identify ceftolozane/tazobactam dosing schemes that optimized the probability of target attainment (PTA) against infections due to MDR-PA with ceftolozane/tazobactam MICs between 4 and 32 mg/L across different categories of renal function...
October 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29065098/effects-of-sodium-nitrite-on-renal-function-and-blood-pressure-in-hypertensive-vs-healthy-study-participants-a-randomized-placebo-controlled-crossover-study
#5
Jeppe B Rosenbæk, Bodil G Hornstrup, Andreas N Jørgensen, Jesper Mortensen, Erling B Pedersen, Jesper N Bech
OBJECTIVE: Nitric oxide is a key player in regulating vascular tone. Impaired endothelial nitric oxide synthesis plays an important role in hypertension. Replenishing of nitric oxide by sodium nitrite (NaNO2) has not been investigated in patients with essential hypertension (EHT). We aimed to determine the effects of NaNO2 on blood pressure (BP) and renal sodium and water regulation in patients with EHT compared with healthy control study participants (CON). METHODS: In a placebo-controlled, crossover study, we infused 240 μg NaNO2/kg/h or isotonic saline for 2 h in 14 EHT and 14 CON...
October 23, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/29058601/role-of-renal-function-in-risk-assessment-of-target-non-attainment-after-standard-dosing-of-meropenem-in-critically-ill-patients-a-prospective-observational-study
#6
Lisa Ehmann, Michael Zoller, Iris K Minichmayr, Christina Scharf, Barbara Maier, Maximilian V Schmitt, Niklas Hartung, Wilhelm Huisinga, Michael Vogeser, Lorenz Frey, Johannes Zander, Charlotte Kloft
BACKGROUND: Severe bacterial infections remain a major challenge in intensive care units because of their high prevalence and mortality. Adequate antibiotic exposure has been associated with clinical success in critically ill patients. The objective of this study was to investigate the target attainment of standard meropenem dosing in a heterogeneous critically ill population, to quantify the impact of the full renal function spectrum on meropenem exposure and target attainment, and ultimately to translate the findings into a tool for practical application...
October 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28961812/maximally-effective-dosing-regimens-of-meropenem-in-patients-with-septic-shock
#7
Fredrik Sjövall, Abdulaziz S Alobaid, Steven C Wallis, Anders Perner, Jeffrey Lipman, Jason A Roberts
Objectives: To use a population pharmacokinetic approach to define maximally effective meropenem dosing recommendations for treatment of Acinetobacter baumannii and Pseudomonas aeruginosa infections in a large cohort of patients with septic shock. Methods: Adult patients with septic shock and conserved renal function, treated with meropenem, were eligible for inclusion. Seven blood samples were collected during a single dosing interval and meropenem concentrations were measured by a validated HPLC-MS/MS method...
September 12, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28936957/-pk-pd-of-vancomycin-in-patients-with-severe-acute-pancreatitis-combined-with-augmented-renal-clearance
#8
Juan He, Enqiang Mao, Feng Jing, Huiting Jiang, Wenyun Xu, Wanhua Yang, Erzhen Chen
OBJECTIVE: To evaluate the serum trough concentration and the pharmacokinetics/pharmacodynamics (PK/PD) of vancomycin in patients with severe acute pancreatitis (SAP), and analyze the effect of vancomycin continuous infusion for optimizing the characteristics of its PK/PD. METHODS: The inhospital patients with SAP received vancomycin treatment and admitted to emergency intensive care unit (EICU) of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2011 to December 2016 were enrolled...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28926966/augmented-renal-clearance-in-critical-illness-an-important-consideration-in-drug-dosing
#9
REVIEW
Sherif Hanafy Mahmoud, Chen Shen
Augmented renal clearance (ARC) is a manifestation of enhanced renal function seen in critically ill patients. The use of regular unadjusted doses of renally eliminated drugs in patients with ARC might lead to therapy failure. The purpose of this scoping review was to provide and up-to-date summary of the available evidence pertaining to the phenomenon of ARC. A literature search of databases of available evidence in humans, with no language restriction, was conducted. Databases searched were MEDLINE (1946 to April 2017), EMBASE (1974 to April 2017) and the Cochrane Library (1999 to April 2017)...
September 16, 2017: Pharmaceutics
https://www.readbyqxmd.com/read/28863094/augmented-renal-clearance-in-critically-ill-pediatric-patients-does-it-impact-the-outcome-of-pharmacotherapy
#10
John N van den Anker, Catherijne A J Knibbe, Dick Tibboel
No abstract text is available yet for this article.
September 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28756331/association-between-augmented-renal-clearance-and-clinical-failure-of-antibiotic-treatment-in-brain-injured-patients-with-ventilator-acquired-pneumonia-a-preliminary-study
#11
Cédric Carrie, Merry Bentejac, Vincent Cottenceau, Françoise Masson, Laurent Petit, Jean-François Cochard, François Sztark
OBJECTIVES: This preliminary study aimed to determine whether augmented renal clearance (ARC) impacts negatively on the clinical outcome in traumatic brain-injured patients (TBI) treated for a first episode of ventilator-acquired pneumonia (VAP). METHODS: During a 5-year period, all TBI patients who had developed VAP were retrospectively reviewed to assess variables associated with clinical failure in multivariate analysis. Clinical failure was defined as an impaired clinical response with a need for escalating antibiotics during treatment and/or within 15 days after the end-of-treatment...
July 26, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28752387/vitamin-and-trace-element-deficiencies-in-the-pediatric-dialysis-patient
#12
Lyndsay A Harshman, Kathy Lee-Son, Jennifer G Jetton
Pediatric dialysis patients are at risk of nutritional illness secondary to deficiencies in water-soluble vitamins and trace elements. Unlike 25-OH vitamin D, most other vitamins and trace elements are not routinely monitored in the blood and, consequently, the detection of any deficiency may not occur until significant complications develop. Causes of vitamin and trace element deficiency in patients on maintenance dialysis patient are multifactorial, ranging from diminished nutritional intake to altered metabolism as well as dialysate-driven losses of water-soluble vitamins and select trace elements...
July 27, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28699888/predicting-augmented-renal-clearance-using-estimated-glomerular-filtration-rate-in-critically-ill-children%C3%A2
#13
Bongjin Lee, Jongyoon Kim, June Dong Park, Hyun Mi Kang, Yoon Sook Cho, Kwi Suk Kim
AIMS: Measured glomerular filtration rate (mGFR) is often used to identify augmented renal clearance (ARC). However, in the clinical setting, estimated GFR (eGFR) is obtained more quickly and inexpensively. We aimed to determine whether eGFR can identify ARC by evaluating the correlation between the eGFR and vancomycin trough level (VTL). MATERIALS AND METHODS: We retrospectively reviewed the records of patients aged ≤ 18 years who underwent vancomycin therapeutic drug monitoring at our tertiary hospital from July 2009 to June 2014...
September 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28694457/characterisation-of-preproendothelin-1-derived-peptides-identifies-endothelin-like-domain-peptide-as-a-modulator-of-endothelin-1
#14
Jale Yuzugulen, Julie A Douthwaite, Elizabeth G Wood, Inmaculada C Villar, Nimesh S A Patel, James Jegard, Hubert Gaertner, Irène Rossitto-Borlat, Keith Rose, Oliver Hartley, Pedro R Cutillas, Amrita Ahluwalia, Roger Corder
Endothelin-1 (ET-1) is involved in the pathogenesis of cardiac and renal diseases, and in the progression of tumour growth in cancer, but current diagnosis and treatment remain inadequate. Peptides derived from the 212 amino acid precursor preproendothelin-1 (ppET-1) may have utility as biomarkers, or cause biological effects that are unaffected by endothelin receptor antagonists. Here, we used specific immunoassays and LC-MS/MS to identify NT-proET-1 (ppET-1[18-50]), Endothelin-Like Domain Peptide (ELDP, ppET-1[93-166]) and CT-proET-1 (ppET-1[169-212]) in conditioned media from cultured endothelial cells...
July 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28678812/augmented-renal-clearance-is-not-a-risk-factor-for-mortality-in-enterobacteriaceae-bloodstream-infections-treated-with-appropriate-empiric-antimicrobials
#15
Jason P Burnham, Scott T Micek, Marin H Kollef
The main objective of the study was to assess whether augmented renal clearance was a risk factor for mortality in a cohort of patients with Enterobacteriaceae sepsis, severe sepsis, or septic shock that all received appropriate antimicrobial therapy within 12 hours. Using a retrospective cohort from Barnes-Jewish Hospital, a 1,250-bed teaching hospital, we collected data on individuals with Enterobacteriaceae sepsis, severe sepsis, and septic shock who received appropriate initial antimicrobial therapy between June 2009 and December 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28640009/augmented-renal-clearance-using-population-based-pharmacokinetic-modeling-in-critically-ill-pediatric-patients
#16
Sean N Avedissian, Erin Bradley, Diana Zhang, John S Bradley, Lama H Nazer, Tri M Tran, Austin Nguyen, Jennifer Le
OBJECTIVES: The objectives of this study were to: 1) evaluate the prevalence of augmented renal clearance in critically ill pediatric patients using vancomycin clearance; 2) derive the pharmacokinetic model that best describes vancomycin clearance in critically ill pediatric patients; and 3) correlate vancomycin clearance with creatinine clearance estimated by modified Schwartz or Cockcroft-Gault. DESIGN: Retrospective, two-center, cohort study from 2003 to 2016...
September 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28444760/vancomycin-levels-are-frequently-subtherapeutic-in-critically-ill-patients-a-prospective-observational-study
#17
V Bakke, H Sporsem, E Von der Lippe, I Nordøy, Y Lao, H C Nyrerød, L Sandvik, K R Hårvig, J F Bugge, E Helset
BACKGROUND: Appropriate utilization of vancomycin is important to attain therapeutic targets while avoiding clinical failure and the development of antimicrobial resistance. Our aim was to observe the use of vancomycin in an intensive care population, with the main focus on achievement of therapeutic serum concentrations (15-20 mg/l) and to evaluate how this was influenced by dose regimens, use of guidelines and therapeutic drug monitoring. METHODS: A prospective observational study was carried out in the intensive care units at two tertiary hospitals in Norway...
July 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28363806/novel-role-of-insulin-in-the-regulation-of-glucose-excretion-by-mourning-doves-zenaida-macroura
#18
Karen L Sweazea, Eldon J Braun, Richard Sparr
In mammals, insulin primarily lowers plasma glucose (PGlu) by increasing its uptake into tissues. Studies have also shown that insulin lowers PGlu in mammals by modulating glomerular filtration rate (GFR). Birds have naturally high PGlu and, although insulin administration significantly decreases glucose concentrations, birds are resistant to insulin-mediated glucose uptake into tissues. Since prior work has not examined the effects of insulin on GFR in birds, the purpose of the present study was to assess whether insulin can augment renal glucose excretion and thereby lower PGlu...
June 2017: Zoology: Analysis of Complex Systems, ZACS
https://www.readbyqxmd.com/read/28286115/association-between-augmented-renal-clearance-and-clinical-outcomes-in-patients-receiving-%C3%AE-lactam-antibiotic-therapy-by-continuous-or-intermittent-infusion-a-nested-cohort-study-of-the-bling-ii-randomised-placebo-controlled-clinical-trial
#19
Andrew A Udy, Joel M Dulhunty, Jason A Roberts, Joshua S Davis, Steven A R Webb, Rinaldo Bellomo, Charles Gomersall, Charudatt Shirwadkar, Glenn M Eastwood, John Myburgh, David L Paterson, Therese Starr, Sanjoy K Paul, Jeffrey Lipman
Augmented renal clearance (ARC) is known to influence β-lactam antibiotic pharmacokinetics. This substudy of the BLING-II trial aimed to explore the association between ARC and patient outcomes in a large randomised clinical trial. BLING-II enrolled 432 participants with severe sepsis randomised to receive β-lactam therapy by continuous or intermittent infusion. An 8-h creatinine clearance (CLCr) measured on Day 1 was used to identify ARC, defined as CLCr ≥ 130 mL/min. Patients receiving any form of renal replacement therapy were excluded...
May 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28264846/substantial-impact-of-altered-pharmacokinetics-in-critically-ill-patients-on-the-antibacterial-effects-of-meropenem-evaluated-via-the-dynamic-hollow-fiber-infection-model
#20
Phillip J Bergen, Jürgen B Bulitta, Carl M J Kirkpatrick, Kate E Rogers, Megan J McGregor, Steven C Wallis, David L Paterson, Roger L Nation, Jeffrey Lipman, Jason A Roberts, Cornelia B Landersdorfer
Critically ill patients frequently have substantially altered pharmacokinetics compared to non-critically ill patients. We investigated the impact of pharmacokinetic alterations on bacterial killing and resistance for commonly used meropenem dosing regimens. A Pseudomonas aeruginosa isolate (MICmeropenem 0.25 mg/liter) was studied in the hollow-fiber infection model (inoculum ∼10(7.5) CFU/ml; 10 days). Pharmacokinetic profiles representing critically ill patients with augmented renal clearance (ARC), normal, or impaired renal function (creatinine clearances of 285, 120, or ∼10 ml/min, respectively) were generated for three meropenem regimens (2, 1, and 0...
May 2017: Antimicrobial Agents and Chemotherapy
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