Cefiderocol is Not Sequestered in an Ex Vivo Extracorporeal Membrane Oxygenation (ECMO) Circuit.

IF 1.9 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Angela V Berry, Allison Conelius, Jason A Gluck, David P Nicolau, Joseph L Kuti
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引用次数: 1

Abstract

Background and objective: Extracorporeal membrane oxygenation (ECMO) is used in critically ill patients that require respiratory and/or cardiac support. Cefiderocol is a novel siderophore antibiotic that may require use in infected critically ill patients supported by ECMO. The objective of this study was to determine the loss of cefiderocol through an ex vivo adult ECMO circuit using a Quadrox-iD oxygenator.

Methods: A 3/8-inch, simulated, ex vivo closed-loop ECMO circuit was prepared with a Quadrox-iD adult oxygenator and primed with fresh whole blood. Cefiderocol was administered into the circuit to achieve a starting concentration of approximately 90 mg/L. Post-oxygenator blood samples were collected at 0, 0.25, 0.5, 1, 2, 4, 6, 12, and 24 h after the addition of the drug to determine the loss in the circuit. A glass control jar was prepared with the same blood matrix and maintained at the same temperature to determine drug degradation. The experiment was conducted in triplicate. The rate of cefiderocol loss in the ECMO circuit was compared with that in the control by one-way analysis of variance.

Results: At 0 h, the difference between the pre- and post-oxygenator concentrations was - 4 ± 4% (range 0 to - 7%). After 24 h, the cefiderocol percent reduction was similar between the ECMO circuit and control (50% ± 13 vs. 50% ± 9, p = 1.0).

Conclusions: The degradation rate of cefiderocol did not differ significantly within the ECMO circuit and control, suggesting no loss due to sequestration or adsorption. Pharmacokinetic studies in patients supported by ECMO are warranted to determine final dosing recommendations.

Abstract Image

体内体外膜氧合(ECMO)回路中的头孢羟氨苄不会被螯合。
背景和目的:体外膜氧合(ECMO)用于需要呼吸和/或心脏支持的重症患者。头孢羟氨苄是一种新型嗜苷抗生素,可能需要用于由 ECMO 支持的受感染重症患者。本研究的目的是确定头孢羟氨苄在使用 Quadrox-iD 氧合器的体外成人 ECMO 循环中的流失量:方法:使用 Quadrox-iD 成人氧合器准备了一个 3/8 英寸的模拟体外闭环 ECMO 回路,并用新鲜全血进行引流。向回路中注入头孢总碱,使起始浓度达到约 90 毫克/升。在添加药物后的 0、0.25、0.5、1、2、4、6、12 和 24 小时采集充氧后的血液样本,以确定回路中的损失。用相同的血液基质制备了一个玻璃对照瓶,并保持在相同的温度下,以确定药物降解情况。实验一式三份。通过单因素方差分析比较了头孢哌酮在 ECMO 循环中的损耗率与对照组的损耗率:结果:0 小时时,供氧前和供氧后的浓度差为 - 4 ± 4%(范围为 0 至 - 7%)。24 小时后,ECMO 循环与对照组的头孢羟氨苄降解率相似(50% ± 13 vs. 50% ± 9,p = 1.0):结论:头孢羟氨苄的降解率在 ECMO 循环和对照组之间没有明显差异,表明没有因螯合或吸附而造成损失。有必要对接受 ECMO 支持的患者进行药代动力学研究,以确定最终剂量建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
64
审稿时长
>12 weeks
期刊介绍: Hepatology International is a peer-reviewed journal featuring articles written by clinicians, clinical researchers and basic scientists is dedicated to research and patient care issues in hepatology. This journal focuses mainly on new and emerging diagnostic and treatment options, protocols and molecular and cellular basis of disease pathogenesis, new technologies, in liver and biliary sciences. Hepatology International publishes original research articles related to clinical care and basic research; review articles; consensus guidelines for diagnosis and treatment; invited editorials, and controversies in contemporary issues. The journal does not publish case reports.
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