TABLE 1.
Patient characteristics and pharmacokinetic data for colistin in plasma samples from patients undergoing CVVH
| Characteristica | Patient 1 | Patient 2 |
|
|---|---|---|---|
| Before CVVH | During CVVH | ||
| Age (yr)/gender | 68/male | 37/male | |
| % TBSA burn | 11 | 51 | |
| CVVH delivered dose (mean ± SD) (ml/kg/h) | 38.1 ± 11.0 | 28.0 ± 3.7 | |
| Weight (kg) | 136.4 | 86.6 | 102.3 |
| Urine output (ml/kg/h) | 0.2 | 1.6 | 0.9 |
| Machine and filter | Prismaflex, HF1400 | NxStage, CAR500 | |
| Prefilter fluid replacement (liters/h) | 2 | 3 | |
| CMS dose (mg/kg) | 2.2 | 1.5 | 2.2 |
| Colistin Cmax (μg/ml) | 13.6 (2.2 free) | 3.4 (0.4 free) | 6.7 (0.6 free) |
| Css.avg (mg/ml) | 9.3 | 4.2 | 2.3 |
| AUC24 (μg · h/ml) | 222.2 (18.2 free) | 55.0 (6.0 free) | 100.0 (8.7 free)b |
| V (liters) | 86.1 | 99.7 | |
| t1/2 (h) | 22 | 11.9 | |
| Total clearance (liters/h) | 2.7 | 4.7 | |
| CVVH clearance (liters/h) | 1.4 | 0.04 | |
| % CVVH clearance | 51.6 | ||
| Sieving coefficient | 0.49 | 0.17b | |
| % Free colistin (mean ± SD) | 11.9 ± 9.2 | 13.7 ± 6.4 | 10.9 ± 4.6 |
| % Colistin A (mean ± SD) | 64.8 ± 1.4 | 67.7 ± 0.4 | 68.6 ± 2.1 |
| % Colistin B (mean ± SD) | 14.1 ± 1.7 | 10.9 ± 4.6 | 10.0 ± 2.4 |
| MIC at which AUC24/MIC was ≥60 (μg/ml) | 2 | 0.75 | 1 |
a
Cmax, maximum concentration; t1/2, half-life.
b
Only 0- to 8-h data available due to filter clotting.