Impact of haemolysis on vancomycin disposition in a full-term neonate treated with extracorporeal membrane oxygenation

Pavla Pokorná, Martin Šíma*, Dick Tibboel, Ondřej Slanař

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

Introduction: Extracorporeal membrane oxygenation (ECMO) is a lifesaving support technology for potentially reversible neonatal cardiac and/or respiratory failure. Pharmacological consequences of ECMO-induced haemolysis in neonates are not well understood. Case report: We report a case report of a full-term neonate treated for congenital diaphragmatic hernia and sepsis with ECMO and with vancomycin. While the population elimination half-life of 7 h was estimated, fitting of the simulated population pharmacokinetic profile to truly observed drug concentration points resulted in the personalized value of 41 h. Discussion: The neonate developed ECMO-induced haemolysis with subsequent acute kidney injury resulting in prolonged drug elimination. Whole blood/serum ratio of 0.79 excluded possibility of direct increase of vancomycin serum concentration during haemolysis. Conclusion: Vancomycin elimination may be severely prolonged due to ECMO-induced haemolysis and acute kidney injury, while hypothesis of direct increase of vancomycin levels by releasing the drug from blood cells during haemolysis has been disproved.

Original languageEnglish
Pages (from-to)864-867
Number of pages4
JournalPerfusion (United Kingdom)
Volume36
Issue number8
Early online date17 Nov 2020
DOIs
Publication statusPublished - Nov 2021

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the project MH CZ-DRO-VFN64165 in the Czech Republic, by the Charles University project PROGRES Q25/LF1 and SVV 260523, by an unrestricted research grant of the Intensive Care Unit of the ErasmusMC-Sophia Children?s Hospital, and by the project UNCE204064 (the Innovative Medicines Initiative 2, grant agreement No 777389 from the European Union?s Horizon 2020 and EFPIA).

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the project MH CZ-DRO-VFN64165 in the Czech Republic, by the Charles University project PROGRES Q25/LF1 and SVV 260523, by an unrestricted research grant of the Intensive Care Unit of the ErasmusMC-Sophia Children’s Hospital, and by the project UNCE204064 (the Innovative Medicines Initiative 2, grant agreement No 777389 from the European Union’s Horizon 2020 and EFPIA).

Publisher Copyright:
© The Author(s) 2020.

Fingerprint

Dive into the research topics of 'Impact of haemolysis on vancomycin disposition in a full-term neonate treated with extracorporeal membrane oxygenation'. Together they form a unique fingerprint.

Cite this