Interaction of azithromycin and methylprednisolone with ex-vivo extracorporeal membrane oxygenation circuits (ECMO).

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Perfusion-Uk Pub Date : 2024-11-05 DOI:10.1177/02676591241297401
Andrew Chevalier, Autumn McKnite, Aviva Whelan, Carina Imburgia, Joseph E Rower, Kevin M Watt, Danielle J Green
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Abstract

Background: Azithromycin and methylprednisolone are two medications that are commonly used in patients who require ECMO support. Unfortunately, ECMO support can decrease drug concentrations through adsorption to circuit components. Such interactions have not been well described for either azithromycin or methylprednisolone. This study determined the extraction of these medications by ECMO circuits in an ex-vivo system.

Methods: Medications were administered to closed-loop, blood-primed ECMO circuits to attain target therapeutic concentrations. Drug concentration remaining in the circuit was measured over 6 h. The difference in medication recovery was compared between the ECMO circuits and controls using two-sample t-tests.

Results: Concentrations of azithromycin and methylprednisolone remained constant in control experiments over time, indicating medication stability in blood. There was no statistical difference in percent recovery after 6 h between control experiments and the ECMO circuits for either azithromycin (p = .32) or methylprednisolone (p = .17).

Discussion: Azithromycin and methylprednisolone did not significantly interact with ex-vivo ECMO circuits. While these studies do not account for all in-vivo pharmacokinetic changes that may occur as a result of ECMO and critical illness, they suggest that standard dosing may be adequate to achieve therapeutic concentrations of azithromycin and methylprednisolone.

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阿奇霉素和甲基强的松龙与体外膜氧合回路(ECMO)的相互作用。
背景:阿奇霉素和甲基强的松龙是两种常用于需要 ECMO 支持的患者的药物。遗憾的是,ECMO 支持可通过吸附回路组件而降低药物浓度。关于阿奇霉素和甲基强的松龙的这种相互作用还没有很好的描述。本研究确定了 ECMO 循环在体外系统中提取这些药物的情况:方法:在闭环血液灌流 ECMO 循环中给药,以达到目标治疗浓度。采用双样本 t 检验比较了 ECMO 循环和对照组之间药物回收率的差异:结果:在对照实验中,阿奇霉素和甲基强的松龙的浓度随着时间的推移保持稳定,表明药物在血液中的稳定性。阿奇霉素(p = .32)或甲基强的松龙(p = .17)在 6 小时后的恢复百分比在对照实验和 ECMO 循环之间没有统计学差异:讨论:阿奇霉素和甲基强的松龙与体外 ECMO 循环无明显相互作用。虽然这些研究没有考虑到 ECMO 和危重病可能导致的所有体内药代动力学变化,但它们表明,标准剂量可能足以使阿奇霉素和甲基强的松龙达到治疗浓度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Perfusion-Uk
Perfusion-Uk 医学-外周血管病
CiteScore
3.00
自引率
8.30%
发文量
203
审稿时长
6-12 weeks
期刊介绍: Perfusion is an ISI-ranked, peer-reviewed scholarly journal, which provides current information on all aspects of perfusion, oxygenation and biocompatibility and their use in modern cardiac surgery. The journal is at the forefront of international research and development and presents an appropriately multidisciplinary approach to perfusion science.
期刊最新文献
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