急性肾衰竭患者在持续静静脉血液滤过和血液透析滤过过程中美罗培南的清除情况。
Elimination of meropenem during continuous veno-venous haemofiltration and haemodiafiltration in patients with acute renal failure.
作者信息
Valtonen M, Tiula E, Backman J T, Neuvonen P J
机构信息
Department of Medicine, Division of Infectious Diseases and Nephrology, Helsinki University Central Hospital, Helsinki, Finland.
出版信息
J Antimicrob Chemother. 2000 May;45(5):701-4. doi: 10.1093/jac/45.5.701.
Meropenem elimination was studied in six patients with acute renal failure on continuous venovenous haemofiltration (CVVH) or continuous veno-venous haemodiafiltration (CVVHDF) 1 L/h and 2 L/h for 12 h. Meropenem 1 g was given iv over three dialysis periods, and plasma, ultrafiltrate/dialysate and urine concentrations of meropenem were determined. The half-life of meropenem was significantly longer (P < 0.05) during CVVH (7.5 +/- 2.0 h; mean +/- S.D.) than during CVVHDF 1 L/h (5.6 +/- 1.4 h) or 2 L/h (4.8 +/- 1.2 h). Meropenem clearance was 3.27 +/- 2.30 L/h, 4.72 +/- 2.69 L/h and 5.71 +/- 3.58 L/h in CVVH, CVVHDF 1 L/h and CVVHDF 2 L/h, respectively (P < 0.05 between CVVH and CVVHDF). Patients with renal failure on CVVHDF 1 or 2 L/h should be treated with meropenem 1 g bid; 500 mg tid may be enough for patients on CVVH.
在6例接受持续静静脉血液滤过（CVVH）或持续静静脉血液透析滤过（CVVHDF）（1L/h和2L/h，持续12小时）的急性肾衰竭患者中研究了美罗培南的清除情况。在三个透析时段内静脉注射1g美罗培南，并测定美罗培南的血浆、超滤液/透析液及尿液浓度。CVVH期间美罗培南的半衰期（7.5±2.0小时；均值±标准差）显著长于（P < 0.05）CVVHDF 1L/h（5.6±1.4小时）或2L/h（4.8±1.2小时）期间。CVVH、CVVHDF 1L/h和CVVHDF 2L/h中美罗培南的清除率分别为3.27±2.30L/h、4.72±2.69L/h和5.71±3.58L/h（CVVH与CVVHDF之间P < 0.05）。接受1L/h或2L/h CVVHDF治疗的肾衰竭患者应以1g美罗培南每日两次进行治疗；接受CVVH治疗的患者每日三次500mg可能足够。
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