Population Pharmacokinetics of Vancomycin in Intensive Care Patients with the Time-Varying Status of Temporary Mechanical Circulatory Support or Continuous Renal Replacement Therapy

Autor: Meng-Ta Tsai, Wei-Chun Wang, Jun-Neng Roan, Chwan-Yau Luo, Chen-Hsi Chou
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Infectious Diseases and Therapy, Vol 13, Iss 12, Pp 2617-2635 (2024)
Druh dokumentu: article
ISSN: 2193-8229
2193-6382
DOI: 10.1007/s40121-024-01071-5
Popis: Abstract Introduction This study characterized the population pharmacokinetics (PK) of vancomycin in patients treated with and without continuous renal replacement therapy (CRRT) or temporary mechanical circulatory support (tMCS), including extracorporeal membrane oxygenation or extracorporeal ventricular assist device. Methods Critically ill adults with and without tMCS or CRRT prescribed vancomycin were enrolled for population PK modeling. Monte Carlo simulation provided dosing recommendations based on the probability of target attainment (PTA), achieving a 24-h area under curve (AUC24h) of 400–600 mg*h/L. Results Twenty-five patients with 184 plasma samples were analyzed. The median age was 61.0 years. The final model was a two-compartment PK model. CRRT, serum creatinine, and body weight were significant predictors of clearance. CRRT was a covariate on the central volume of distribution. tMCS significantly decreased the intercompartmental clearance. The simulated mean trough levels at the 48th hour were lower in the tMCS group (13.4 versus 14.2 mg/dL in non-tMCS, p
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