Impact of haemolysis on vancomycin disposition in a full-term neonate treated with extracorporeal membrane oxygenation
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu kazuistiky, časopisecké články, práce podpořená grantem
PubMed
33200670
DOI
10.1177/0267659120973595
Knihovny.cz E-zdroje
- Klíčová slova
- ECMO, acute kidney injury, haemolysis, neonate, pharmacokinetics, vancomycin,
- MeSH
- hemolýza MeSH
- lidé MeSH
- mimotělní membránová oxygenace * škodlivé účinky MeSH
- novorozenec MeSH
- respirační insuficience * MeSH
- vankomycin škodlivé účinky MeSH
- vrozená brániční kýla * MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
- Názvy látek
- vankomycin 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.
