Related Experiment Videos
Elimination of vancomycin by continuous arteriovenous hemofiltration
Child Nephrology and Urology
|January 1, 1988
Summary
Continuous arteriovenous hemofiltration (CAVH) significantly removes vancomycin in pediatric patients with renal failure. Careful dosage adjustments and monitoring are crucial when using vancomycin during CAVH therapy.
Area of Science:
- Nephrology
- Pharmacology
- Critical Care Medicine
Background:
- Continuous arteriovenous hemofiltration (CAVH) is increasingly used for pediatric acute renal failure and fluid/electrolyte imbalances.
- Vancomycin is often administered concurrently for sepsis management in these critically ill patients.
Observation:
- This study evaluated vancomycin removal during CAVH in a 15-month-old male with renal failure.
- Vancomycin concentrations in ultrafiltrate averaged 90.4% of serum concentrations over 79 hours across two CAVH treatments.
- The polysulfone membranes used in CAVH demonstrated significant drug removal.
Findings:
- CAVH removed 0.53-1.11 mg of vancomycin per hour at serum concentrations of 12.4-25.4 mg/L.
- CAVH contributed 66.2% to the total vancomycin clearance, establishing it as a major elimination route.
- Calculated CAVH vancomycin clearance ranged from 0.039-0.050 L/h.
Implications:
- Vancomycin elimination is significantly influenced by CAVH in pediatric patients.
- Therapeutic drug monitoring and adjusted dosing regimens are essential for vancomycin in patients undergoing CAVH.
- This highlights the need for pharmacokinetics-based adjustments in critically ill pediatric populations requiring renal replacement therapy and antibiotic treatment.