Cefepime Extraction by Extracorporeal Life Support Circuits

Extracorporeal life support (ECLS) devices are lifesaving for critically ill patients with multi-organ dysfunction. Despite this, supported ECLS at high risk ECLS-related complications, including nosocomial infections, and mortality rates in this patient population. The suspected to be, part, a result of significantly altered drug disposition by the circuit, resulting suboptimal antimicrobial dosing. Cefepime is commonly used serious infections. dosing not routinely guided therapeutic monitoring treatment success dependent upon percentage time interval that concentration remains above minimum inhibitory organism. This ex vivo study measured extraction cefepime continuous renal replacement therapy (CRRT) extracorporeal membrane oxygenation (ECMO) circuits. was studied four closed-loop CRRT circuit configurations single ECMO configuration. Circuits were primed physiologic human blood–plasma mixture dosed achieve concentrations. Serial blood samples collected over concentrations quantified using validated assays. In experiments, rapidly cleared dialysis, hemofiltration, hemodiafiltration, greater than 96% eliminated from 2 hours. circuits, mean recovery similar both standard control. Mean (standard deviation) circuits ( n = 6) 39.2% (8.0) 24 control 3) hours 52.2% (1.5). hemodiafiltration but minimally adsorbed either or Dosing adjustments needed CRRT.