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[Pharmacokinetics of vancomycin in continuous veno-venous hemofiltration]
Qin Gu1, Zhang-hua Zhu, Min Ge
1Department of Intensive Care Unit, The Medical College of Nanjing University Affiliated Drum-Tower Hospital, Nanjing 210008, Jiangsu, China.
Objective:
To investigate the pharmacokinetics of vancomycin in continuous veno-venous hemofiltration(CVVH) in order to determine appropriate vancomycin dosing strategies for patients receiving CVVH.
Methods:
The serum concentrations of vancomycin were measured by TDx and the pharmacokinetics parameters were calculated.
Results:
The pharmacokinetics of vancomycin during CVVH was fitted with open two-compartment model. At the beginning of CVVH, the pharmacokinetic parameters were: maximum plasma concentration (Cmax)=22.18 mg/L, minimum plasma concentration attained (Cmin)=5.82 mg/L, half-life of drug (T1/2)=5.75 h, apparent volume of distribution (Vd)=21.92 L, total body clearance of drug(CL)=3.49 L/h. On the 16 d of CVVH, the pharmacokinetic parameters were Cmax=38.70 mg/L, Cmin=16.50 mg/L, T1/2=33.32 h, Vd=12.92 L, CL=0.38 L/h.
Conclusion:
CVVH can significantly augment the clearance of vancomycin in acute renal failure patients. Dosing strategies for individualization of vancomycin therapy in patients receiving CVVH are proposed. Monitoring the serum concentration during CVVH is necessary.