scholarly journals Modification of Nutrition Therapy During Continuous Renal Replacement Therapy in Critically Ill Pediatric Patients: A Narrative Review and Recommendations

2018 ◽  
Vol 34 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Joop Jonckheer ◽  
Klaar Vergaelen ◽  
Herbert Spapen ◽  
Manu L. N. G. Malbrain ◽  
Elisabeth De Waele
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Pediatric Patients ◽  
Nutrition Therapy ◽  
Narrative Review

Characteristics and Clinical Outcomes of Prolonged Continuous Renal Replacement Therapy in Critically Ill Pediatric Patients

2020 ◽  
Vol 21 (6) ◽  
pp. 571-577 ◽  
Author(s):  
Naile Tufan Pekkucuksen ◽  
Ayse Akcan Arikan ◽  
Sarah J. Swartz ◽  
Poyyapakkam Srivaths ◽  
Joseph R. Angelo
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Pediatric Patients

Lacosamide Pharmacokinetics in a Critically Ill Patient During Continuous Renal Replacement Therapy

2018 ◽  
Vol 33 (3) ◽  
pp. 395-398 ◽  
Author(s):  
Patrick M. Wieruszewski ◽  
Arnaldo Lopez-Ruiz ◽  
Robert C. Albright ◽  
Jennifer E. Fugate ◽  
Erin Frazee Barreto
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Drug Exposure ◽  
Critically Ill Patient ◽  
Therapeutic Drug ◽  
Intermittent Hemodialysis ◽  
Pharmacokinetic Studies ◽  
Extracorporeal Removal

The objective of this study is to describe the pharmacokinetics of lacosamide in a critically ill adult during continuous venovenous hemofiltration (CVVH). A 78-year-old male developed sepsis and acute kidney injury following cardiac surgery. He was initially treated with intermittent hemodialysis but developed nonconvulsive status epilepticus at the end of the first session and was subsequently initiated on CVVH. In addition to lorazepam boluses, levetiracetam, and midazolam infusion, he was loaded with lacosamide 400 mg intravenously and started on 200 mg intravenously twice daily as maintenance therapy. Noncompartmental modeling of lacosamide pharmacokinetics revealed significant extracorporeal removal, a volume of distribution of 0.69 L/kg, elimination half-life of 13.6 hours, and peak and trough concentrations of 7.4 and 3.7 mg/L, respectively (goal trough, 5-10 mg/L). We found significant extracorporeal removal of serum lacosamide during CVVH, which was higher than previously reported. This led to subtherapeutic concentrations and decreased overall antiepileptic drug exposure. The relationship between serum lacosamide concentrations and clinical efficacy is not well understood; thus, therapeutic drug monitoring is not routinely recommended. Yet, we demonstrated that measuring serum lacosamide concentrations in the critically ill population during continuous renal replacement therapy may be useful to individualize dosing programs. Further pharmacokinetic studies of lacosamide may be necessary to generate widespread dosing recommendations.

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