Ofloxacin clearance during continuous hemofiltration

Mueller, Bruce A.; Pasko, Deborah A.; Sowinski, Kevin M.

doi:10.1053/j.ajkd.2003.08.043

Cited by 1 publication

(1 citation statement)

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“…Different alternatives have been suggested to explain increased sieving coeffi cient: the requirement for the electroneutrality across the hemofi ltration membrane [26,39] , weak bindings to plasma proteins [40] or alterations of the fraction of drug available for transport across the fi lter membrane because of the passage through the extracorporeal circuit [26] . The issue of lower Scs has been much less discussed in the literature [41] ; adsorption to hemofi lter or the Gibbs-Donnan effect has been suggested [15] . Some authors defend that different affi nities of drugs on whole blood binding sites could be the reason of the deviation of drug sieving coeffi cients from predicted values [42] .…”

Section: Discussionmentioning

confidence: 99%

Elimination of Piperacillin and Tazobactam by Renal Replacement Therapies with AN69 and Polysulfone Hemofilters: Evaluation of the Sieving Coefficient

et al. 2006

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Background/Aim: Piperacillin-tazobactam is commonly used to treat infections in ICU patients. Controversial data have been published about the sieving/saturation coefficient (Sc/Sa) of piperacillin during continuous renal replacement therapies (CRRT). The objective was to evaluate the Sc/Sa of piperacillin-tazobactam during continuous venovenous hemofiltration (CVVH) and continuous venovenous hemodialysis (CVVHD) using AN69 and polysulfone. Methods: Ringer lactate, BSA-containing Ringer lactate and plasma were circulated at 150 ml/min. The ultrafiltrate/dialysis flow was kept at 1,500 ml/min. A bolus was injected and samples were taken. Drugs were measured using HPLC. Sc/Sa was calculated according to standard formula. Results: Free passage of drugs through the membranes was reported with protein free solutions. In the presence of proteins the Sc/Sa lowered and correlated to protein free fraction. Polysulfone had a significantly higher permeability than AN69 during CVVH. Conclusion: Drug binding to albumin contributes to the decrease of the Sc/Sa of piperacillin but it does not completely justify the in vivo value obtained by some authors.

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