Laboratory 103B, Centro de Investigaciones Médicas, Departamento de Medicina Intensiva, Facultad de Medicina y Hospital Clínico, Pontificia Universidad Católica de Chile, Marcoleta 391, Santiago 8330024, Chile.
State Key Laboratory of Chirosciences, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
Sensors (Basel). 2018 May 4;18(5):1424. doi: 10.3390/s18051424.
The use of antibiotics is mandatory in patients during extracorporeal membrane oxygenation (ECMO) support. Clinical studies have shown high variability in the antibiotic concentrations, as well as sequestration of them by the ECMO circuit, suggesting that the doses and/or interval administration used during ECMO may not be adequate. Thus, a fast response sensor to estimate antibiotic concentrations in this setting would contribute to improve dose adjustments. The biosensor PenP has been shown to have a dynamic range, sensitivity and specificity useful for pharmacokinetic (PK) tests in healthy subjects. However, the use of this biosensor in the context of a complex critical condition, such as ECMO during acute respiratory distress syndrome (ARDS), has not been tested.
To describe, by using PenP Biosensor, the pharmacokinetic of meropenem in a 24-h animal ARDS/ECMO model.
The PK of meropenem was evaluated in a swine model before and during ECMO.
The PK parameters such as maximum concentration (Cmax), elimination rate constant (Ke), and cleareance (Cl), were not significantly altered during ECMO support.
(a) ECMO does not affect the PK of meropenem, at least during the first 24 h; and (b) PenP has the potential to become an effective tool for making medical decisions associated with the dose model of antibiotics in a critical patient context.
在体外膜肺氧合（ECMO）支持期间，患者必须使用抗生素。临床研究表明，抗生素浓度存在很大的变异性，同时 ECMO 回路也会将其隔离，这表明 ECMO 期间使用的剂量和/或间隔给药可能不足。因此，在这种情况下，一种快速反应的传感器来估计抗生素浓度将有助于改善剂量调整。PenP 生物传感器已被证明在健康受试者的药代动力学（PK）测试中具有有用的动态范围、灵敏度和特异性。然而，在复杂的危急情况下，如急性呼吸窘迫综合征（ARDS）期间的 ECMO，尚未测试这种生物传感器的使用。
使用 PenP 生物传感器描述 24 小时动物 ARDS/ECMO 模型中美罗培南的药代动力学。
在 ECMO 之前和期间评估猪模型中美罗培南的 PK。
最大浓度（Cmax）、消除速率常数（Ke）和清除率（Cl）等 PK 参数在 ECMO 支持期间没有明显改变。
（a）至少在最初的 24 小时内，ECMO 不会影响美罗培南的 PK；（b）PenP 有可能成为在危急患者情况下与抗生素剂量模型相关的医疗决策的有效工具。
