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Impact of haemolysis on vancomycin disposition in a full-term neonate treated with extracorporeal membrane oxygenation
P. Pokorná, M. Šíma, D. Tibboel, O. Slanař
Language English Country Great Britain
Document type Case Reports, Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Hemolysis MeSH
- Humans MeSH
- Extracorporeal Membrane Oxygenation * adverse effects MeSH
- Infant, Newborn MeSH
- Respiratory Insufficiency * MeSH
- Vancomycin adverse effects MeSH
- Hernias, Diaphragmatic, Congenital * MeSH
- Check Tag
- Humans MeSH
- Infant, Newborn MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Research Support, Non-U.S. Gov't MeSH
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is a lifesaving support technology for potentially reversible neonatal cardiac and/or respiratory failure. Pharmacological consequences of ECMO-induced haemolysis in neonates are not well understood. CASE REPORT: We report a case report of a full-term neonate treated for congenital diaphragmatic hernia and sepsis with ECMO and with vancomycin. While the population elimination half-life of 7 h was estimated, fitting of the simulated population pharmacokinetic profile to truly observed drug concentration points resulted in the personalized value of 41 h. DISCUSSION: The neonate developed ECMO-induced haemolysis with subsequent acute kidney injury resulting in prolonged drug elimination. Whole blood/serum ratio of 0.79 excluded possibility of direct increase of vancomycin serum concentration during haemolysis. CONCLUSION: Vancomycin elimination may be severely prolonged due to ECMO-induced haemolysis and acute kidney injury, while hypothesis of direct increase of vancomycin levels by releasing the drug from blood cells during haemolysis has been disproved.
References provided by Crossref.org
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