Dose Optimization of Meropenem in Patients on Veno-Arterial Extracorporeal Membrane Oxygenation in Critically Ill Cardiac Patients: Pharmacokinetic/Pharmacodynamic Modeling
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Kang, Soyoung | - |
dc.contributor.author | Yang, Seungwon | - |
dc.contributor.author | Hahn, Jongsung | - |
dc.contributor.author | Jang, June Young | - |
dc.contributor.author | Min, Kyoung Lok | - |
dc.contributor.author | Wi, Jin | - |
dc.contributor.author | Chang, Min Jung | - |
dc.date.accessioned | 2023-01-04T05:40:11Z | - |
dc.date.available | 2023-01-04T05:40:11Z | - |
dc.date.created | 2023-01-04 | - |
dc.date.issued | 2022-11 | - |
dc.identifier.issn | 2077-0383 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/86431 | - |
dc.description.abstract | Background: Our objective was to determine an optimal dosage regimen of meropenem in patients receiving veno-arterial extracorporeal membrane oxygenation (V-A ECMO) by developing a pharmacokinetic/pharmacodynamic (PK/PD) model. Methods: This was a prospective cohort study. Blood samples were collected during ECMO (ECMO-ON) and after ECMO (ECMO-OFF). The population pharmacokinetic model was developed using nonlinear mixed-effects modeling. A Monte Carlo simulation was used (n = 10,000) to assess the probability of target attainment. Results: Thirteen adult patients on ECMO receiving meropenem were included. Meropenem pharmacokinetics was best fitted by a two-compartment model. The final pharmacokinetic model was: CL (L/h) = 3.79 x 0.44(CRRT), central volume of distribution (L) = 2.4, peripheral volume of distribution (L) = 8.56, and intercompartmental clearance (L/h) = 21.3. According to the simulation results, if more aggressive treatment is needed (100% fT > MIC target), dose increment or extended infusion is recommended. Conclusions: We established a population pharmacokinetic model for meropenem in patients receiving V-A ECMO and revealed that it is not necessary to adjust the dosage depending on V-A ECMO. Instead, more aggressive treatment is needed than that of standard treatment, and higher dosage is required without continuous renal replacement therapy (CRRT). Also, extended infusion could lead to better target attainment, and we could provide updated nomograms of the meropenem dosage regimen. | - |
dc.language | 영어 | - |
dc.language.iso | en | - |
dc.publisher | MDPI | - |
dc.relation.isPartOf | JOURNAL OF CLINICAL MEDICINE | - |
dc.title | Dose Optimization of Meropenem in Patients on Veno-Arterial Extracorporeal Membrane Oxygenation in Critically Ill Cardiac Patients: Pharmacokinetic/Pharmacodynamic Modeling | - |
dc.type | Article | - |
dc.type.rims | ART | - |
dc.description.journalClass | 1 | - |
dc.identifier.wosid | 000887472000001 | - |
dc.identifier.doi | 10.3390/jcm11226621 | - |
dc.identifier.bibliographicCitation | JOURNAL OF CLINICAL MEDICINE, v.11, no.22 | - |
dc.description.isOpenAccess | Y | - |
dc.identifier.scopusid | 2-s2.0-85142627442 | - |
dc.citation.title | JOURNAL OF CLINICAL MEDICINE | - |
dc.citation.volume | 11 | - |
dc.citation.number | 22 | - |
dc.contributor.affiliatedAuthor | Wi, Jin | - |
dc.type.docType | Article | - |
dc.subject.keywordAuthor | meropenem | - |
dc.subject.keywordAuthor | extracorporeal membrane oxygenation | - |
dc.subject.keywordAuthor | ECMO | - |
dc.subject.keywordAuthor | dosage optimization | - |
dc.subject.keywordAuthor | population pharmacokinetics | - |
dc.subject.keywordPlus | CONTINUOUS-INFUSION | - |
dc.subject.keywordPlus | PHARMACOKINETIC CHANGES | - |
dc.subject.keywordPlus | CARDIOGENIC-SHOCK | - |
dc.subject.keywordPlus | PK/PD INDEXES | - |
dc.subject.keywordPlus | LIFE-SUPPORT | - |
dc.subject.keywordPlus | STABILITY | - |
dc.subject.keywordPlus | ADULTS | - |
dc.subject.keywordPlus | PHARMACODYNAMICS | - |
dc.subject.keywordPlus | ANTIBIOTICS | - |
dc.subject.keywordPlus | THERAPY | - |
dc.relation.journalResearchArea | General & Internal Medicine | - |
dc.relation.journalWebOfScienceCategory | Medicine, General & Internal | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.
1342, Seongnam-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do, Republic of Korea(13120)031-750-5114
COPYRIGHT 2020 Gachon University All Rights Reserved.
Certain data included herein are derived from the © Web of Science of Clarivate Analytics. All rights reserved.
You may not copy or re-distribute this material in whole or in part without the prior written consent of Clarivate Analytics.