Table 1.
Data on extracorporeal removal and PK/PD parameters obtained from literature analysis
| 2016; Roger et al. | 2005; Meyer et al. | 2005; Meyer et al. | 2004; Fiaccadori et al. | 2004; Pea et al. | 2016. Roger et al. | 2012 Carcelero et al. | 2006; Mauro et al. | 2014; Zoller et al. | 2012; Ide et al. | 2003; Kraft et al. | 2015; Villa et al. | 2014; Zoller et al. | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Prospective RCT | Prospective observational study | Prospective observational study | Prospective observational study | Prospective observational case report | Prospective RCT | Prospective observational case report | Prospective observational case report | Prospective observational study | Abstract | Prospective observational case report | Prospective observational case report | Prospective observational study | ||
| Treatment parameters | Number of procedures | 8 | 7 | 13 | 2 | 2 | 9 | 2 | 1 | 2 | 14 | 1 | 3 | 3 |
| Treatment | CVVH-post | CVVH-post | CVVH-post | CVVH-pre | CVVH-pre | CVVHDF-post | CVVHDF-pre | CVVHDF-pre | CVVHDF-? | CVVHDF-? | CVVHDF-? | CVVHD | CVVHD | |
| Membrane | HF | HF | HF | HF | HF | HF | HF | HF | HF | HF | HF | HCO PAES | HF | |
| PS | PS | PS | PAN | PS | PS | PAN | PAN | PS | PS | PS | PS | |||
| 1.2 m2 | 1.2 m2 | 0.9 m2 | 1.65 m2 | 1.25 m2 | 1.2 m2 | 0.9 m2 | 1 m2 | 1.4 m2 | ? | 1.6 m2 | 1.1 m2 | 1.8 m2 | ||
| Qb (ml/min) | 200 (185–245) | 189 ± 15 | 185 ± 15 | 150 | 125 (120–130) | 200 (165–200) | 165 (150–180) | 200 | 130 (100–150) | 79.3 ± 2.7 | 200 | 150 | 120 (80–150) | |
| Qd (L/h) | 1.14a | 1 (1–1) | 1.2a | 1.4 (1.2–1.5) | 0.52 ± 0.31 | 2 | 3a (2.9–3.2) | 1.6 (1–2) | ||||||
| Qf (L/h) | 1.67a | 2.5 ± 0.6 | 2.3 ± 0.4 | 2.25 (2–2.5) | 2 (2–2) | 1.22a | 1.5 (1–2) | 0.2 | 1.5 (1–2) | 0.33 ± 0.15 | 0.75 | - | ||
| QfNET (ml/h) | 0–200 | 115 (80–150) | 0–200 | 100 (50–150) | 125 (50–200) | 774 | 100 | 100 (50–200) | ||||||
| UFNET (L) | 3.6 (0.2–4.3) | 1.1 (0.4–1.6) | ||||||||||||
| BW | 76 (55–92) | 90 ± 22a | 83 ± 15a | 64 (57–72) | 64.5 (54–75) | 76 (55–92) | 67.5 (55–80) | 125 | 100 | 86 (83–90) | ||||
| Prescribed dose (ml/kg/h) | 30 | 35 (35–35) | 33.6 (29–39) | 30 | 41.2a (27–56) | 11.2 | 27.7a | 30 | ||||||
| Effective time of treatment (min) | 715 (697–751) | 675 (630–720) | 745 (645–733) | 3990 | 5000 | |||||||||
| APACHE II | 30 ± 5 (24–40) | 26 ± 8 (7–32) | 27 (27–27) | 27 (26–28) | 31.5 (28–35) | 25 (23–28) | ||||||||
| SOFA at RRT initiation | 12 (10–16) | 13 (6–17) | 15 (15–15) | 14.3 (13–15) | ||||||||||
| Parameters of CRRT removal | SA/SC (%) | 77 ± 10 (62–86) | 69 ± 10 (53–91) | 59 (56–61) | 84 (76–92) | 78 (74–82) | 0.86 ± 0.03 | 79 | 74 (66–80) | |||||
| Qef (L/h) | 1.98a | 2.5 ± 0.6 (1.5–3) | 2.3 ± 0.4 (1.5–3) | 2.1 (2.1–2.2) | 2.4a | 2.6a (2.2–3.1) | 1.4a | 2.8 | 3a (2.9–3.2) | |||||
| Qef (ml/kg/h) | 26a | 27.8a (16.3–40) | 27.7a (15–37.5) | 32.2a | 30 | |||||||||
| XCRRT (mg) | 89.9 (75–105) | 237 (160–314) | 218.9 (154–283) | 50.1 | 197.6 (154–266) | |||||||||
| CLCRRT (L/h) | 2.3 ± 0.9 (1.3–4.3) | 1.6 ± 0.5 (0.9–2.7) | 1.2 (1.2–1.3) | 1.4 (1-2–1.6) | 2.1 (1.8–2.3) | 0.9 | 2.2 | 2.3 (2.1–2.5) | ||||||
| PK and PD parameters | Cmax (mg/L) | ~19b | 12.4 ± 2.3 (7.6–10.5) | 16.9 ± 3.8 (11.4–21.9) | 19.93 (15.9–23.9) | 28.67 (17.1–40.3) | ~18b | 18.85 (16.5 − 21.2) | 15.3 | 16.4 | 17.13 (10.4–23.5) | |||
| Cmin (mg/L) | ~6b | 1.7 ± 1.2 (0.3–3.7) | 2 ± 1.9 (0.3 − 8) | 14.1 (6.5–21.7) | ~4b | 5.4 (5.2–5.6) | 3.8 | 9.4 (4.2–14.5) | 7.2 | 6.2 (2.9–10.3) | 8.5 (3.7–18.7) | |||
| T1/2 (h) | 4.6 ± 1.6 (2.4–7.1) | 4.1 ± 1.8 (2.1 − 8.4) | 4.6 (2.6–6.5) | 15.5 (12.5–-18.5) | 6.2 (4.9–7.4) | 8.78 ± 3.74 | 7.5 | 7.7 (6.1–10.1) | ||||||
| AUC0-∞ (mg•h/L) | 227.9 ± 115 | 67.6 (34–118) | 85.7 (40–244) | 444.6 (219–669) | 227.9 ± 115 | 263.5 (214–312) | 105.8a | 303.9 (165–442) | 247.9 ± 107.8 | 208.2 (95–352) | 283.1 (144–453) | |||
| Vd (L) | 26.5 ± 10.3 | 60.5 ± 8.6 (42.9–70.8) | 46.3 ± 11.1 (29.9–70.7) | 31.4 (25.2–37.6) | 67.9 (91.5–44.3) | 26.5 ± 10.3 | 44 (29.2–58.8) | 31 ± 3.8 | 49 | 48.9 (39.9–57.9) | ||||
| CLtot (L/h) | 4.5 | 10.4 ± 3.9 (5.1–17.6) | 8.7 ± 3.0 (2.5–14.7) | 3.6 (1.8–5.5) | 5.9 | 4.5 (3.6–5.3) | 11.3 | 294 ± 1.38 | 5.1 | 3.8 (1.7–6.3) | ||||
| CLCRRT/CLtot (%) | 22.6a | 18.7a | 48.89 (28.7–69.1) | 48.9a (33.9–63.9) | 7.9a | 43.1 | 67.1 (39.6–100) | |||||||
| AUC0-∞/MIC 4 mg/L | 33.8a | 42.8a | 111.1 (54–167) | 65.9a (53–78) | 26.5a | 52.0 (23–88) | ||||||||
| AUC0-∞/MIC 2 mg/L | 67.6a | 85.7a | 222.3 (109–334) | 131.8a (107–156) | 52.9a | 104.1 (47–176) | ||||||||
| AUCfree/MIC 4 mg/L | 35.9 (16–61) | |||||||||||||
| AUCfree/MIC 2 mg/L | 71.8 (33–122) | |||||||||||||
| % T > MIC 4 mg/L | 51 ± 19 (26–88) | 61 ± 36 (31–164) | ||||||||||||
| % T > MIC 2 mg/L | 89 ± 32 (46–137) | 96 ± 50 (48–234) |
aCalculated from data presented in the original paper. bDerived from figures presented in the original paper. Qb blood flow, Qd dialysate flow, Qf replacement flow, Qf NET net ultrafiltration flow, UF NET net ultrafiltrate, BW body weight, APACHE II Acute Physiology and Chronic Health Evaluation II, SOFA Sequential Organ Failure Assessment, SA/SC saturation coefficient or sieving coefficient, Qeff effluent flow, X CRRT total amount of drug eliminated by the extracorporeal treatment, CL CRRT extracorporeal clearance, Cmax antibiotic maximum serum concentration, Cmin antibiotic trough, T 1/2 elimination half-life, AUC area under the curve, Vd volume of distribution, CLtot total clearance