Modulation of Polymorphonuclear Leukocyte Apoptosis in the Critically Ill by Removal of Cytokines with Continuous Hemodiafiltration

2004 ◽  
Vol 22 (2) ◽  
pp. 188-197 ◽  
Author(s):  
Takeshi Hirano ◽  
Hiroyuki Hirasawa ◽  
Shigeto Oda ◽  
Hidetoshi Shiga ◽  
Kazuya Nakanishi ◽  
...  
Keyword(s):  
Critically Ill ◽  
Polymorphonuclear Leukocyte ◽  
Continuous Hemodiafiltration ◽  
Leukocyte Apoptosis

scholarly journals Hsp27 Regulates Akt Activation and Polymorphonuclear Leukocyte Apoptosis by Scaffolding MK2 to Akt Signal Complex

2007 ◽  
Vol 282 (30) ◽  
pp. 21598-21608 ◽  
Author(s):  
Rui Wu ◽  
Hina Kausar ◽  
Paul Johnson ◽  
Diego E. Montoya-Durango ◽  
Michael Merchant ◽  
...  
Keyword(s):  
Polymorphonuclear Leukocyte ◽  
Akt Activation ◽  
Leukocyte Apoptosis

scholarly journals Pharmacokinetics and the optimal regimen for levofloxacin in critically ill patients receiving continuous hemodiafiltration

2015 ◽  
Vol 3 (1) ◽  
Author(s):  
Takeshi Wada ◽  
Masaki Kobayashi ◽  
Yuichi Ono ◽  
Asumi Mizugaki ◽  
Kenichi Katabami ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Continuous Hemodiafiltration ◽  
Optimal Regimen

Evaluation of plasma levels of meropenem in septic patients during extracorporeal blood purification

2021 ◽  
Vol 20 (4) ◽  
pp. 81-94
Author(s):  
Artem V. Marukhov ◽  
Elena V. Murzina ◽  
Mikhail V. Zakharov ◽  
Genrikh A. Sofronov ◽  
Lyudmila V. Buryakova ◽  
...  
Keyword(s):  
Septic Shock ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Selective Adsorption ◽  
Plasma Concentrations ◽  
Blood Purification ◽  
Continuous Hemodiafiltration ◽  
Extracorporeal Blood ◽  
Extracorporeal Blood Purification ◽  
Extracorporeal Support

The relevance. Meropenem is a broad-spectrum carbapenem antibiotic widely used to treat patients with sepsis / septic shock. Critically ill patients are usually supported with one of the forms extracorporeal blood purification. However, data on the effect of various extracorporeal support techniques on the pharmacokinetics and pharmacodynamics of meropenem are insufficient or contradictory. Aim: To evaluate the effectiveness of meropenem dosage regimens in the treatment of septic patients during extracorporeal blood purification. Materials and methods. Plasma concentrations of meropenem were monitored in three critically ill patients with sepsis or septic shock. Patients were treated using various extracorporeal support techniques. Meropenem was used as empirical antibacterial mono- or complex therapy (1 g every 8 or 12 hours). Meropenem concentrations in plasma were determined by validated assay methods on Acquity ultraefficient liquid chromatography (UPLC) H-Class system. Results. It is shown that the meropenem plasma concentration in critically ill patients changes significantly. It was found that the standard meropenem dosing regimens in patients with sepsis / septic shock during continuous hemodiafiltration do not ensure the achievement of the PK/PD target of 100% TMIC for sensitive strains (MIC2 mg/L) and for intermediate resistance pathogens (2MIC8 mg/L). Continuous hemofiltration and selective adsorption of lipopolysaccharide have a less pronounced effect on the clearance of meropenem. Conclusion. To increase the effectiveness of antibacterial therapy, it is necessary to conduct research aimed at developing protocols for dosing antibacterial drugs for the treatment of sepsis during extracorporeal blood purification.

scholarly journals Proposal of a Pharmacokinetically Optimized Dosage Regimen of Antibiotics in Patients Receiving Continuous Hemodiafiltration

2011 ◽  
Vol 55 (12) ◽  
pp. 5804-5812 ◽  
Author(s):  
Takehito Yamamoto ◽  
Nobuhiro Yasuno ◽  
Shoichi Katada ◽  
Akihiro Hisaka ◽  
Norio Hanafusa ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Drug Clearance ◽  
Minor Effect ◽  
Optimal Dosage ◽  
Continuous Hemodiafiltration ◽  
Unbound Fraction ◽  
Artificial Plasma

ABSTRACTThe aim of the study was to quantitatively predict the clearance of three antibiotics, amikacin, vancomycin, and teicoplanin, during continuous hemodiafiltration (CHDF) and to propose their optimal dosage in patients receiving CHDF. For this goal,in vitroCHDF experiments with a polyacrylonitrile (PAN) membrane were first performed using these antibiotics, and then the clearances were compared within vivoCHDF situations determined in 16 critically ill patients. Thein vitroCHDF clearances were described as the product of the outflow rate of a drain (Qoutflow) and the drug unbound fraction in artificial plasma, indicating that drug adsorption to the PAN membrane has minor effect on drug clearance in our settings. The observedin vivoclearances also agreed very well with the predicted values, with a product ofQoutflowand plasma unbound fraction, when residual creatinine clearance (CLCR) was taken into account (within a range of 0.67- to 1.5-fold for 15 of 16 patients). Based on these results, a nomogram of the optimized dosages of amikacin, vancomycin, and teicoplanin was proposed, and it was evident thatQoutflowand residual CLCRare major determinants of the dosage and dosing interval for these antibiotics. Although the applicability needs to be confirmed with another type of membrane or higherQoutflow, our nomogram can help determine the dosage setting in critically ill patients receiving CHDF.

scholarly journals Doripenem Pharmacokinetics in Critically Ill Patients Receiving Continuous Hemodiafiltration (CHDF)

2010 ◽  
Vol 130 (1) ◽  
pp. 87-94 ◽  
Author(s):  
Seigo HIDAKA ◽  
Koji GOTO ◽  
Satoshi HAGIWARA ◽  
Hideo IWASAKA ◽  
Takayuki NOGUCHI
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Continuous Hemodiafiltration
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