id,collection,dc.contributor.author,dc.date.accessioned,dc.date.available,dc.date.issued,dc.description.abstract[en],dc.format.extent,dc.identifier.uri,dc.language,dc.rights.uri,dc.subject.ddc,dc.subject[en],dc.title,dc.type,dcterms.accessRights.openaire,dcterms.bibliographicCitation.articlenumber,dcterms.bibliographicCitation.doi,dcterms.bibliographicCitation.journaltitle,dcterms.bibliographicCitation.number,dcterms.bibliographicCitation.url,dcterms.bibliographicCitation.volume,dcterms.isPartOf.eissn,refubium.affiliation,refubium.affiliation.other,refubium.resourceType.isindependentpub,refubium.resourceType.provider "f2a5023c-c094-4aca-b622-9d2566cdf3e3","fub188/16","Scharf, Christina||Weinelt, Ferdinand||Schroeder, Ines||Paal, Michael||Weigand, Michael||Zoller, Michael||Irlbeck, Michael||Kloft, Charlotte||Briegel, Josef||Liebchen, Uwe","2022-06-20T12:27:04Z","2022-06-20T12:27:04Z","2022","Background Hemadsorption of cytokines is used in critically ill patients with sepsis or septic shock. Concerns have been raised that the cytokine adsorber CytoSorb® unintentionally adsorbs vancomycin. This study aimed to quantify vancomycin elimination by CytoSorb®. Methods Critically ill patients with sepsis or septic shock receiving continuous renal replacement therapy and CytoSorb® treatment during a prospective observational study were included in the analysis. Vancomycin pharmacokinetics was characterized using population pharmacokinetic modeling. Adsorption of vancomycin by the CytoSorb® was investigated as linear or saturable process. The final model was used to derive dosing recommendations based on stochastic simulations. Results 20 CytoSorb® treatments in 7 patients (160 serum samples/24 during CytoSorb®-treatment, all continuous infusion) were included in the study. A classical one-compartment model, including effluent flow rate of the continuous hemodialysis as linear covariate on clearance, best described the measured concentrations (without CytoSorb®). Significant adsorption with a linear decrease during CytoSorb® treatment was identified (p < 0.0001) and revealed a maximum increase in vancomycin clearance of 291% (initially after CytoSorb® installation) and a maximum adsorption capacity of 572 mg. For a representative patient of our cohort a reduction of the area under the curve (AUC) by 93 mg/L*24 h during CytoSorb® treatment was observed. The additional administration of 500 mg vancomycin over 2 h during CytoSorb® attenuated the effect and revealed a negligible reduction of the AUC by 4 mg/L*24 h. Conclusion We recommend the infusion of 500 mg vancomycin over 2 h during CytoSorb® treatment to avoid subtherapeutic concentrations.","8 Seiten","https://refubium.fu-berlin.de/handle/fub188/35342||http://dx.doi.org/10.17169/refubium-35058","eng","https://creativecommons.org/licenses/by/4.0/","600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::615 Pharmakologie, Therapeutik","Vancomycin||Critically ill patients||CytoSorb®||Sepsis||Pharmacokinetics||Adsorption","Does the cytokine adsorber CytoSorb® reduce vancomycin exposure in critically ill patients with sepsis or septic shock? a prospective observational study","Wissenschaftlicher Artikel","open access","44","10.1186/s13613-022-01017-5","Annals of Intensive Care","1","https://doi.org/10.1186/s13613-022-01017-5","12","2110-5820","Biologie, Chemie, Pharmazie","Institut für Pharmazie:::48f26436-28c9-4d76-8633-d686b5be6cbf:::600","no","WoS-Alert"