keyword
https://read.qxmd.com/read/38533293/a-new-dosing-frontier-retrospective-assessment-of-effluent-flow-rates-and-residual-renal-function-among-critically-ill-patients-receiving-continuous-renal-replacement-therapy
#1
JOURNAL ARTICLE
Damini Lakshmipathy, Xiaoyi Ye, Joseph L Kuti, David P Nicolau, Tomefa E Asempa
OBJECTIVES: In 2020, cefiderocol became the first Food and Drug Administration-approved medication with continuous renal replacement therapy (CRRT) dosing recommendations based on effluent flow rates ( Q E ). We aimed to evaluate the magnitude and frequency of factors that may influence these recommendations, that is, Q E intrapatient variability and residual renal function. DESIGN: Retrospective observational cohort study. SETTING: ICUs within Hartford Hospital (890-bed, acute-care hospital) in Connecticut from 2017 to 2023...
April 2024: Critical care explorations
https://read.qxmd.com/read/38509986/effect-of-continuous-renal-replacement-therapy-on-the-clinical-efficacy-and-pharmacokinetics-of-polymyxin-b-in-the-treatment-of-severe-pulmonary-infection
#2
JOURNAL ARTICLE
Xi Wang, Mingming Zhou, Xiyu Wang, Lian Liu, Chuan Zhang
OBJECTIVE: This study aimed to evaluate the pharmacokinetics of polymyxin B in patients with ventilator-associated pneumonia caused by multi-drug resistant bacteria, and to analyze the effect of continuous renal replacement therapy (CRRT) on pharmacokinetics of polymyxin B. METHODS: Thirty-five patients with ventilator-associated pneumonia caused by multi-drug resistant bacteria admitted to our hospital from June 2021 to January 2022 were selected as the subjects...
March 30, 2024: Heliyon
https://read.qxmd.com/read/38483544/pharmacokinetics-of-polymyxin-b-in-different-populations-a-systematic-review
#3
REVIEW
Xing Wang, Wenqiang Xiong, Maolian Zhong, Yan Liu, Yuqing Xiong, Xiaoyi Yi, Xiaosong Wang, Hong Zhang
BACKGROUND AND OBJECTIVES: Despite being clinically utilized for the treatment of infections, the limited therapeutic range of polymyxin B (PMB), along with considerable interpatient variability in its pharmacokinetics and frequent occurrence of acute kidney injury, has significantly hindered its widespread utilization. Recent research on the population pharmacokinetics of PMB has provided valuable insights. This study aims to review relevant literature to establish a theoretical foundation for individualized clinical management...
March 14, 2024: European Journal of Clinical Pharmacology
https://read.qxmd.com/read/38409748/antimicrobial-dosing-recommendations-during-continuous-renal-replacement-therapy-different-databases-different-doses
#4
JOURNAL ARTICLE
Aysel Pehlivanli, Tuğba Yanik Yalçin, Fatma İrem Yeşiler, Helin Şahintürk, Özlem Kurt Azap, Pınar Zeyneloğlu, Bilgen Başgut
Meticulous antimicrobial management is essential among critically ill patients with acute kidney injury, particularly if renal replacement therapy is needed. Many factors affect drug removal in patients undergoing continuous renal replacement therapy CRRT. In this study, we aimed to compare current databases that are frequently used to adjust CRRT dosages of antimicrobial drugs with the gold standard. The dosage recommendations from various databases for antimicrobial drugs eliminated by CRRT were investigated...
February 26, 2024: Journal of Chemotherapy
https://read.qxmd.com/read/38178624/pharmacokinetic-of-ceftazidime-avibactam-in-a-critically-ill-patient-under-high-volume-continuous-venovenous-haemodiafiltration-a-first-paediatric-case-report
#5
Charlotte Collignon, Sihem Benaboud, Inès Gana, Matthieu Bendavid, Benjamin Fournier, Mehdi Oualha, Charles de Marcellus
Ceftazidime-avibactam is a novel cephalosporin/B-lactamase inhibitor developed in the context of increasing resistance. This case reports the pharmacokinetics of ceftazidime-avibactam in a critically ill child under continuous renal replacement (CRRT) therapy for fluid overload. The patient was a 6-month-old female with sepsis due to bloodstream infection to Stenotrophomonas maltophilia following stem cell transplantation for severe combined immunodeficiency. CRRT was started on Day 2. Concentrations have been monitored using liquid chromatography-tandem mass spectrometry...
January 4, 2024: British Journal of Clinical Pharmacology
https://read.qxmd.com/read/38107537/anakinra-removal-by-continuous-renal-replacement-therapy-an-ex-vivo-analysis
#6
JOURNAL ARTICLE
Samuel D J Dubinsky, Kevin M Watt, Carina E Imburgia, Autumn M Mcknite, J Porter Hunt, Cassandra Rice, Joseph E Rower, Andrea N Edginton
OBJECTIVES: Patients with sepsis are at significant risk for multiple organ dysfunction, including the lungs and kidneys. To manage the morbidity associated with kidney impairment, continuous renal replacement therapy (CRRT) may be required. The extent of anakinra pharmacokinetics in CRRT remains unknown. The objectives of this study were to investigate the anakinra-circuit interaction and quantify the rate of removal from plasma. DESIGN: The anakinra-circuit interaction was evaluated using a closed-loop ex vivo CRRT circuit...
December 2023: Critical care explorations
https://read.qxmd.com/read/38099629/meropenem-extraction-by-ex-vivo-extracorporeal-life-support-circuits
#7
JOURNAL ARTICLE
Christopher Cole Honeycutt, Charles Griffin McDaniel, Autumn McKnite, J Porter Hunt, Aviva Whelan, Danielle J Green, Kevin M Watt
BACKGROUND: Meropenem is a broad-spectrum carbapenem-type antibiotic commonly used to treat critically ill patients infected with extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae. As many of these patients require extracorporeal membrane oxygenation (ECMO) and/or continuous renal replacement therapy (CRRT), it is important to understand how these extracorporeal life support circuits impact meropenem pharmacokinetics. Based on the physicochemical properties of meropenem, it is expected that ECMO circuits will minimally extract meropenem, while CRRT circuits will rapidly clear meropenem...
December 2023: Journal of Extra-corporeal Technology
https://read.qxmd.com/read/38063399/population-pharmacokinetics-of-fluconazole-in-critically-ill-patients-receiving-extracorporeal-membrane-oxygenation-and-continuous-renal-replacement-therapy-an-asap-ecmo-study
#8
JOURNAL ARTICLE
Emmanuel Novy, Mohd H Abdul-Aziz, Vesa Cheng, Fay Burrows, Hergen Buscher, Amanda Corley, Arne Diehl, Eileen Gilder, Bianca J Levkovich, Shay McGuinness, Jenny Ordonez, Rachael Parke, Suzanne Parker, Vincent Pellegrino, Claire Reynolds, Sam Rudham, Steven C Wallis, Susan A Welch, John F Fraser, Kiran Shekar, Jason A Roberts
This multicenter study describes the population pharmacokinetics (PK) of fluconazole in critically ill patients receiving concomitant extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) and includes an evaluation of different fluconazole dosing regimens for achievement of target exposure associated with maximal efficacy. Serial blood samples were obtained from critically ill patients on ECMO and CRRT receiving fluconazole. Total fluconazole concentrations were measured in plasma using a validated chromatographic assay...
December 8, 2023: Antimicrobial Agents and Chemotherapy
https://read.qxmd.com/read/38007827/-renal-replacement-therapy-in-cancer-patients-with-aki
#9
REVIEW
Marco Pozzato, Roberta Fenoglio, Nunziante Caruso, Cecilia Ceruti, Giorgio Amore, Savino Sciascia, Dario Roccatello
Acute renal failure (AKI) is a high-prevalence complication in patients with cancer. The risk of AKI after cancer diagnosis is 18% in the first year, 27% in the fifth year, and 40% of critically ill patients with cancer require renal replacement therapy. The causes of AKI may be pre-renal due to hemodynamic problems, related to the cancer, metabolic complications, and drug or surgical treatment. One must preventively protect renal function by hydration, use of non-nephrotoxic drugs, correction of anemia, prevention of contrast agent-induced AKI (CI-AKI), and adjustment of cancer therapy in patients with CKD...
October 3, 2023: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://read.qxmd.com/read/37946296/lacosamide-dosing-in-patients-receiving-continuous-renal-replacement-therapy
#10
JOURNAL ARTICLE
Weerachai Chaijamorn, Sathian Phunpon, Thanompong Sathienluckana, Taniya Charoensareerat, Sutthiporn Pattharachayakul, Dhakrit Rungkitwattanakul, Nattachai Srisawat
BACKGROUND: Lacosamide is one of the anticonvulsants used in critically ill patients. This study aimed to suggest appropriate lacosamide dosing regimens in critically ill patients receiving continuous renal replacement therapy (CRRT) via Monte Carlo simulations. METHODS: Mathematical models were created using published demographic and pharmacokinetics in adult critically ill patients. CRRT modalities with different effluent rates were added into the models. Lacosamide regimens were evaluated on the probability of target attainment (PTA) using pharmacodynamic targets of trough concentrations and area under the curve within a range of 5-10 mg/L and 80...
November 9, 2023: Journal of Intensive Care
https://read.qxmd.com/read/37926072/the-clearance-of-midazolam-and-metabolites-during-continuous-renal-replacement-therapy-in-critically-ill-patients-with-covid-19
#11
JOURNAL ARTICLE
Tim J L Smeets, Hilde R H de Geus, Abraham J Valkenburg, Lauren Baidjoe, Diederik A M P J Gommers, Birgit C P Koch, Nicole G M Hunfeld, Henrik Endeman
INTRODUCTION: Midazolam-based continuous intravenous sedation in patients admitted to the intensive care unit (ICU) was a necessity during the COVID-19 pandemic. However, benzodiazepine-based sedation is associated with a high incidence of benzodiazepine-related delirium and additional days on mechanical ventilation. Due to the requirement of high midazolam doses in combination with the impaired renal clearance (CL) of the pharmacological active metabolite 1-OH-midazolam-glucuronide (10% compared to midazolam), ICU patients with COVID-19 and continuous renal replacement therapy (CRRT) were at risk of unintended prolonged sedation...
November 3, 2023: Blood Purification
https://read.qxmd.com/read/37866621/pharmacokinetics-of-gs-441524-the-active-metabolite-of-remdesivir-in-patients-receiving-continuous-renal-replacement-therapy-a-case-series
#12
Asami Nishikawa, Isao Ito, Atsushi Yonezawa, Kotaro Itohara, Takeshi Matsubara, Yuki Sato, Katsuyuki Matsumura, Satoshi Hamada, Naoya Tanabe, Shinichi Kai, Eishi Imoto, Kohei Yoshikawa, Shigeru Ohtsuru, Motoko Yanagita, Toyohiro Hirai, Tomohiro Terada
Remdesivir plays a key role in the treatment of coronavirus disease in 2019 (COVID-19). Haemodialysis is sometimes required for hospitalised patients with COVID-19, and patients undergoing haemodialysis are at an increased risk of severe COVID-19. In the present study, we report the serum concentrations of GS-441524, the active metabolite of remdesivir, in four patients undergoing continuous renal replacement therapy (CRRT). Patient 1, a male aged 70s, received a loading dose of 200 mg remdesivir on day 1, followed by 100 mg remdesivir from day 2, according to the package insert as in non-haemodialysis patients...
October 20, 2023: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://read.qxmd.com/read/37848106/high-concentrations-of-nirmatrelvir-ritonavir-in-critically-ill-patients-receiving-continuous-renal-replacement-therapy
#13
JOURNAL ARTICLE
Dong Rong, Huang Yizhen, Ling Xiao, Li Lu, Yu Wenqiao, Jiang Saiping
Nirmatrelvir/ritonavir is a highly efficacious agent against severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. Although dose adjustment is recommended in patients with renal impairment according to the package insert of Paxlovid (Pfizer), there is no dose recommendation for patients with severe renal impairment who need continuous renal replacement therapy (CRRT). To characterize the features of nirmatrelvir/ritonavir in critically ill Chinese patients undergoing CRRT, therapeutic drug monitoring of nirmatrelvir/ritonavir was applied by a high-performance liquid chromatography-tandem mass spectrometry assay in eight patients...
October 15, 2023: International Journal of Antimicrobial Agents
https://read.qxmd.com/read/37727274/ceftazidime-avibactam-for-carbapenem-resistant-gram-negative-bacteria-infections-a-real-world-experience-in-the-icu
#14
JOURNAL ARTICLE
Jiaxin Yu, Wei Zuo, Hongwei Fan, Jiayu Wu, Luyao Qiao, Benyu Yang, Wenxi Li, Yang Yang, Bo Zhang
PURPOSE: Ceftazidime-avibactam (C-A) is a treatment option for carbapenem-resistant gram-negative bacterial (CR-GNB) infections, but little is known regarding its suitability for the intensive care unit (ICU). The current study aimed to analyze use of C-A for critically ill patients, determine independent predictors of clinical outcome and mortality and explore routine dosages for patients in continuous renal replacement therapy (CRRT). PATIENTS AND METHODS: A single-center, retrospective and observational study was conducted in critically ill patients receiving different C-A-based therapies for CR-GNB infections in a tertiary teaching hospital in Beijing, China...
2023: Infection and Drug Resistance
https://read.qxmd.com/read/37675616/continuous-infusion-of-cefiderocol-in-a-critically-ill-patient-with-continuous-venovenous-haemofiltration
#15
Julia E Möhlmann, Matthijs van Luin, Esther V Uijtendaal, Noël Zahr, Maaike A Sikma
Cefiderocol is a broad-spectrum cephalosporin antibiotic and is indicated in patients with difficult-to-treat Gram-negative bacterial infections. Cefiderocol is applied as a 2-4-times daily prolonged 3-h infusion. The therapeutic target of cefiderocol suggests that continuous infusion (CI) may be advantageous, since it is more likely to achieve 100% of time of the unbound concentration above the minimal inhibitory concentration (MIC). However, limited information on cefiderocol as CI has been assessed. We present a case of a critically ill 37-year-old woman with continuous venovenous haemofiltration (CVVH) treated with a CI of cefiderocol for multidrug-resistant Pseudomonas aeruginosa...
December 2023: British Journal of Clinical Pharmacology
https://read.qxmd.com/read/37572979/interaction-of-ceftazidime-and-clindamycin-with-extracorporeal-life-support
#16
JOURNAL ARTICLE
J Porter Hunt, Autumn M McKnite, Danielle J Green, Aviva J Whelan, Carina E Imburgia, Kevin M Watt
BACKGROUND: Ceftazidime and clindamycin are commonly prescribed to critically ill patients who require extracorporeal life support such as ECMO and CRRT. The effect of ECMO and CRRT on the disposition of ceftazidime and clindamycin is currently unknown. METHODS: Ceftazidime and clindamycin extraction were studied with ex vivo ECMO and CRRT circuits primed with human blood. The percent recovery of these drugs over time was calculated to determine the degree of interaction between these drugs and circuit components...
August 10, 2023: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://read.qxmd.com/read/37501116/analysis-of-uroseptic-shock-after-ureteroscopy-for-ureteral-calculi-during-pregnancy-a-case-report
#17
JOURNAL ARTICLE
Wen Tang, Zhifei Xie, Mingwen Liu, ZeJu Zhao, Tao Wu
BACKGROUND: Uroseptic shock secondary to ureteral calculi during pregnancy is rare. It is characterized by rapid onset, rapid progression, aggressive disease, limited treatment, poor prognosis, and a mortality rate higher than 20% with improper or delayed management. A clear diagnosis is made based on typical clinical symptoms and abdominal ultrasound, often requiring combined multidisciplinary treatment and the simultaneous release of the obstruction. The high mortality rate is mainly related to inappropriate early treatment of stones and infections or failure to intervene in a timely manner...
July 27, 2023: BMC Urology
https://read.qxmd.com/read/37458062/vancomycin-dosing-in-high-intensity-continuous-renal-replacement-therapy-a-retrospective-cohort-study
#18
JOURNAL ARTICLE
Nina Srour, Chelsea Lopez, Luma Succar, Peter Nguyen
INTRODUCTION: An inverse relationship exists between vancomycin serum concentrations and the intensity of continuous renal replacement therapy (CRRT), reflected through the dialysate flow rate (DFR). There remains a lack of evidence to guide initial vancomycin dosing in the setting of high-intensity CRRT (i.e., DFR >30 mL/kg/h). Additionally, recommendations for pharmacokinetic monitoring of vancomycin have transitioned from a trough-based to area under the curve (AUC)-based dosing strategy to optimize efficacy and safety...
October 2023: Pharmacotherapy
https://read.qxmd.com/read/37442487/pharmacokinetics-and-dialytic-clearance-of-baricitinib-during-in-vivo-continuous-veno-venous-hemodialysis-in-a-patient-with-covid-19
#19
JOURNAL ARTICLE
Mary E Palmer, Rachel M Belcher, Anastasia Engeleit, Eric Wenzler, Zackery P Bulman, Scott T Benken, Bcps-Aq Cardiology
PURPOSE: To date, there are no published pharmacokinetic (PK) data for baricitinib in critically ill patients requiring continuous renal replacement therapy (CRRT). This paper describes in detail the plasma PK and dialytic clearance of baricitinib in a patient infected with COVID-19 requiring CRRT in order to suggest dosing strategies in this population. PRINCIPLE FINDINGS: Baricitinib 2 mg daily was used for the treatment of COVID-19 in a critically ill patient on continuous venovenous hemodialysis (CVVHD)...
July 11, 2023: International Journal of Antimicrobial Agents
https://read.qxmd.com/read/37322293/treatment-of-critically-ill-patients-with-cefiderocol-for-infections-caused-by-multidrug-resistant-pathogens-review-of-the-evidence
#20
REVIEW
Pierluigi Viale, Christian E Sandrock, Paula Ramirez, Gian Maria Rossolini, Thomas P Lodise
Appropriate antibiotic treatment for critically ill patients with serious Gram-negative infections in the intensive care unit is crucial to minimize morbidity and mortality. Several new antibiotics have shown in vitro activity against carbapenem-resistant Enterobacterales (CRE) and difficult-to-treat resistant Pseudomonas aeruginosa. Cefiderocol is the first approved siderophore beta-lactam antibiotic with potent activity against multidrug-resistant, carbapenem-resistant, difficult-to-treat or extensively drug-resistant Gram-negative pathogens, which have limited treatment options...
June 15, 2023: Annals of Intensive Care
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