The effect of direct hemoperfusion with polymyxin B immobilized cartridge on meropenem in critically ill patients requiring renal support

Singhan, Wanchana; Vadcharavivad, Somratai; Areepium, Nutthada; Wittayalertpanya, Supeecha; Chaijamorn, Weerachai; Srisawat, Nattachai

doi:10.1016/j.jcrc.2019.02.007

Cited by 8 publications

(11 citation statements)

References 26 publications

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“…Once the cytokine levels were controlled and the patient clinically improved (with reduction in vasopressor support), we discontinued hemoadsorption. This system allows us to shorten the hemoadsorption time, an important step since it can alter the concentrations of certain drugs, such as antibiotics ( 19 , 20 ). Frimmel et al ( 21 ) reported a case of multiorgan dysfunction due to liver failure in a patient with HLH secondary to reactivation of the Herpes simplex virus type 1.…”

Section: Resultsmentioning

confidence: 99%

Case report: Cytokine hemoadsorption in a case of hemophagocytic lymphohistiocytosis secondary to extranodal NK/T-cell lymphoma

et al. 2022

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We discuss a single case of Hemophagocytic lymphohistiocytosis (HLH) due to NK-type non-Hodgkin lymphoma and Epstein-Barr virus reactivation with multiorgan dysfunction and distributive shock in which we performed cytokine hemoadsorption with Cytosorb ®. A full microbiological panel was carried out, including screening for imported disease, standard serologies and cultures for bacterial and fungal infection. A liver biopsy and bone marrow aspirate were performed, confirming the diagnosis. The patients fulfilled the HLH-2004 diagnostic criteria, and according to the 2018 Consensus Statements by the HLH Steering Committee of the Histiocyte Society, dexamethasone and etoposide were started. There was an associated hypercytokinemia and, due to refractory distributive shock, rescue therapy with cytokine hemoadsorption was performed during 24 h (within day 2 and 3 from ICU admission). After starting this procedure, rapid hemodynamic control was achieved with a significant reduction in vasopressor support requirements. This case report highlights that cytokine hemoadsorption can be an effective since rapid decrease in IL-10 levels and a significant hemodynamic improvement was achieved.

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Section: Resultsmentioning

confidence: 99%

Case report: Cytokine hemoadsorption in a case of hemophagocytic lymphohistiocytosis secondary to extranodal NK/T-cell lymphoma

et al. 2022

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“…Indeed, certain pharmacokinetic consequences of hemoadsorption cannot be ruled out. However, recent studies do not show that plasma concentrations of meropenem [14] although it could be possible with other antibiotics such as teicoplanin [15]. In any case, it is important to monitor antibiotic concentrations, especially when the periods of hemoadsorption are very long.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Endotoxin and Cytokine Sequential Hemoadsorption in Septic Shock and Multi-Organ Failure

et al. 2021

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The mortality of septic shock remains high [Ann Intensive Care. 2017;7:19], so apart from usual therapy based on source control and antibiotics, some patients may need rescue therapies. Blood purification systems may play a role by facilitating the nonspecific removal of inflammatory mediators and microbiological toxins. There are different hemoadsorption systems, we describe in this case report the sequential use of Polymyxin B (PMX) endotoxin-adsorbing column (Toraymixin PMX-20R; Toray, Tokyo, Japan) and Cytosorb® (Cytosorbents Corp., New Jersey, USA).

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“…Несмотря на все достоинства применения гемосорбции в терапии сепсиса, существуют данные, демонстрирующие способность некоторых гемосорбентов (Cytosorb (США), Toraymyxin (Япония)) к связыванию антибактериальных препаратов, в том числе меропенема и ванкомицина, что приводит к снижению их свободной фракции в плазме и может препятствовать достижению минимальной ингибирующей концентрации [8]. В отношении гемосорбентов, применяемых в комплексной терапии сепсиса в Республике Беларусь, в частности, «Гемопротеазосорб» и «ЛПС-гемо», исследования их влияния на фармакокинетику антибактериальных препаратов не проводились [9]. В этой связи представляет большой интерес изучение вопроса наличия подобных эффектов у сорбентов, производимых в Республике Беларусь.…”

Section: Introductionunclassified

“…Полученные показатели степени связывания антибиотика используемыми нами гемосорбентами примерно соответствуют иностранным аналогам. Антицитокиновый сорбент CytoSorb (США) в среднем увеличивает клиренс меропенема приблизительно на 6% в сравнении с контрольной группой [13], а гемосорбент на основе иммобилизованного полимиксина B Toraymyxin (Япония) практически не влияет на концентрацию этого антибактериального препарата [14]. Результаты исследования позволяют говорить о неполной селективности гемосорбентов производства РБ и присутствии у них способности к снижению концентрации меропенема в плазме у пациентов с сепсисом.…”

Section: Introductionunclassified

Meropenem Plasma Levels Changes During Extracorporeal Hemoperfusion Through Selective Hemosorbents in Patients With Sepsis Under Complex Intensive Therapy

Белявский¹,

Yakubtsevich²,

Kurbat³

2022

Journal GrSMU

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Background. Sepsis and septic shock are the main causes of death in intensive care units. Hemoperfusion in combination with standard therapy of sepsis reduces mortality by an average of 5-7%, however, there is evidence that hemosorbents can reduce plasma levels of antibacterial drugs. Purpose of the study. Our aim is to investigate the effect of hemoperfusion on the meropenem plasma levels using the sorbents “Hemoproteazosorb” and “LPS-hemo”. Material and methods. 35 patients with sepsis were examined: a control group without the use of hemoperfusion and two experimental groups, in which hemoperfusion with various sorbents was used. Plasma concentration of meropenem was determined by ELISA. Results. In the control group, a decrease in concentration of meropenem was observed in 27% of cases (decrease value 3.81 µg/ml; p<0.25). In the group of “Hemoproteazosorb” - in 54% of cases after hemosorption (1.33 µg/ml; p<0.02); in “LPS-hemo” group - in 50% of cases (3.08 µg/ml; p<0.06). Conclusions. Hemoadsorption can alter the plasma concentration of meropenem, it is necessary to develop methods of correction such as modifying dosing regimens of an antibacterial drug.

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The effect of direct hemoperfusion with polymyxin B immobilized cartridge on meropenem in critically ill patients requiring renal support

Cited by 8 publications

References 26 publications

Case report: Cytokine hemoadsorption in a case of hemophagocytic lymphohistiocytosis secondary to extranodal NK/T-cell lymphoma

Case report: Cytokine hemoadsorption in a case of hemophagocytic lymphohistiocytosis secondary to extranodal NK/T-cell lymphoma

Endotoxin and Cytokine Sequential Hemoadsorption in Septic Shock and Multi-Organ Failure

Meropenem Plasma Levels Changes During Extracorporeal Hemoperfusion Through Selective Hemosorbents in Patients With Sepsis Under Complex Intensive Therapy

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