PDF(Pubmed)
Abstract：
Patients undergoing extracorporeal membrane oxygenation (ECMO) often require therapy with anti-infective drugs. The pharmacokinetics of these drugs may be altered during ECMO treatment due to pathophysiological changes in the drug metabolism of the critically ill and/or the ECMO therapy itself. This study investigates the latter aspect for commonly used anti-infective drugs in an ex vivo setting. A fully functional ECMO device circulated an albumin-electrolyte solution through the ECMO tubes and oxygenator. The antibiotic agents cefazolin, cefuroxim, cefepime, cefiderocol, linezolid and daptomycin and the antifungal agent anidulafungin were added. Blood samples were taken over a period of four hours and drug concentrations were measured via high-pressure liquid chromatography (HPLC) with UV detection. Subsequently, the study analyzed the time course of anti-infective concentrations. The results showed no significant changes in the concentration of any tested anti-infectives throughout the study period. This ex vivo study demonstrates that the ECMO device itself has no impact on the concentration of commonly used anti-infectives. These findings suggest that ECMO therapy does not contribute to alterations in the concentrations of anti-infective medications in severely ill patients.
摘要：
接受体外膜氧合（ECMO）的患者通常需要使用抗感染药物进行治疗。这些药物的药代动力学在ECMO治疗期间可能由于危重病的药物代谢和/或ECMO治疗本身的病理生理变化而改变。本研究调查了离体环境中常用抗感染药物的后一方面。功能齐全的ECMO装置使白蛋白电解质溶液通过ECMO管和充氧器循环。抗生素剂头孢唑林，头孢呋西姆,头孢吡肟,cefiderocol,添加利奈唑胺和达托霉素以及抗真菌剂Anidulafungin。在4小时内采集血样,通过高压液相色谱(HPLC)和UV检测来测量药物浓度。随后，该研究分析了抗感染药物浓度的时程。结果显示在整个研究期间,任何测试的抗感染药的浓度没有显著变化。该离体研究表明,ECMO装置本身对常用抗感染药的浓度没有影响。这些发现表明，ECMO治疗不会导致重症患者抗感染药物浓度的改变。
