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Clinical Validation of Therapeutic Drug Monitoring of Imipenem in Spent Effluent in Critically Ill Patients Receiving Continuous Renal Replacement Therapy: A Pilot Study.

Wen A, Li Z, Yu J, Li R, Cheng S, Duan M, Bai J - PLoS ONE (2016)

Bottom Line: The Pearson correlation coefficient of the imipenem concentrations in plasma and effluent was 0.950 (P<0.0001).The average plasma-to-effluent imipenem concentration ratio was 1.044 (95% confidence interval, 0.975 to 1.114) with Bland-Altman analysis.No statistically significant difference was found in the pharmacokinetic and pharmacodynamic parameters tested in paired plasma and effluent samples with Wilcoxon test.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

ABSTRACT

Objectives: The primary objective of this pilot study was to investigate whether the therapeutic drug monitoring of imipenem could be performed with spent effluent instead of blood sampling collected from critically ill patients under continuous renal replacement therapy.

Methods: A prospective open-label study was conducted in a real clinical setting. Both blood and effluent samples were collected pairwise before imipenem administration and 0.5, 1, 1.5, 2, 3, 4, 6, and 8 h after imipenem administration. Plasma and effluent imipenem concentrations were determined by reversed-phase high-performance liquid chromatography with ultraviolet detection. Pharmacokinetic and pharmacodynamic parameters of blood and effluent samples were calculated.

Results: Eighty-three paired plasma and effluent samples were obtained from 10 patients. The Pearson correlation coefficient of the imipenem concentrations in plasma and effluent was 0.950 (P<0.0001). The average plasma-to-effluent imipenem concentration ratio was 1.044 (95% confidence interval, 0.975 to 1.114) with Bland-Altman analysis. No statistically significant difference was found in the pharmacokinetic and pharmacodynamic parameters tested in paired plasma and effluent samples with Wilcoxon test.

Conclusion: Spent effluent of continuous renal replacement therapy could be used for therapeutic drug monitoring of imipenem instead of blood sampling in critically ill patients.

No MeSH data available.


Related in: MedlinePlus

Plasma and effluent concentrations of imipenem during continuous renal replacement therapy for 10 patients.The X axis represents postinfusion times.
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pone.0153927.g003: Plasma and effluent concentrations of imipenem during continuous renal replacement therapy for 10 patients.The X axis represents postinfusion times.

Mentions: Plasma and effluent concentration-versus-time profiles for imipenem during CRRT for each patient are shown in Fig 3. Pharmacokinetic parameters of imipenem in plasma and effluent are displayed in Table 3. The Wilcoxon test for paired samples showed no statistically significant difference between medians of all pharmacokinetic parameters in plasma and effluent samples.


Clinical Validation of Therapeutic Drug Monitoring of Imipenem in Spent Effluent in Critically Ill Patients Receiving Continuous Renal Replacement Therapy: A Pilot Study.

Wen A, Li Z, Yu J, Li R, Cheng S, Duan M, Bai J - PLoS ONE (2016)

Plasma and effluent concentrations of imipenem during continuous renal replacement therapy for 10 patients.The X axis represents postinfusion times.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836878&req=5

pone.0153927.g003: Plasma and effluent concentrations of imipenem during continuous renal replacement therapy for 10 patients.The X axis represents postinfusion times.
Mentions: Plasma and effluent concentration-versus-time profiles for imipenem during CRRT for each patient are shown in Fig 3. Pharmacokinetic parameters of imipenem in plasma and effluent are displayed in Table 3. The Wilcoxon test for paired samples showed no statistically significant difference between medians of all pharmacokinetic parameters in plasma and effluent samples.

Bottom Line: The Pearson correlation coefficient of the imipenem concentrations in plasma and effluent was 0.950 (P<0.0001).The average plasma-to-effluent imipenem concentration ratio was 1.044 (95% confidence interval, 0.975 to 1.114) with Bland-Altman analysis.No statistically significant difference was found in the pharmacokinetic and pharmacodynamic parameters tested in paired plasma and effluent samples with Wilcoxon test.

View Article: PubMed Central - PubMed

Affiliation: Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

ABSTRACT

Objectives: The primary objective of this pilot study was to investigate whether the therapeutic drug monitoring of imipenem could be performed with spent effluent instead of blood sampling collected from critically ill patients under continuous renal replacement therapy.

Methods: A prospective open-label study was conducted in a real clinical setting. Both blood and effluent samples were collected pairwise before imipenem administration and 0.5, 1, 1.5, 2, 3, 4, 6, and 8 h after imipenem administration. Plasma and effluent imipenem concentrations were determined by reversed-phase high-performance liquid chromatography with ultraviolet detection. Pharmacokinetic and pharmacodynamic parameters of blood and effluent samples were calculated.

Results: Eighty-three paired plasma and effluent samples were obtained from 10 patients. The Pearson correlation coefficient of the imipenem concentrations in plasma and effluent was 0.950 (P<0.0001). The average plasma-to-effluent imipenem concentration ratio was 1.044 (95% confidence interval, 0.975 to 1.114) with Bland-Altman analysis. No statistically significant difference was found in the pharmacokinetic and pharmacodynamic parameters tested in paired plasma and effluent samples with Wilcoxon test.

Conclusion: Spent effluent of continuous renal replacement therapy could be used for therapeutic drug monitoring of imipenem instead of blood sampling in critically ill patients.

No MeSH data available.


Related in: MedlinePlus