Population Pharmacokinetics of Vancomycin in Critically Ill Adult Patients Receiving Extracorporeal Membrane Oxygenation (an ASAP ECMO Study)
Vesa Cheng, Mohd H. Abdul-Aziz, Fay Burrows, Hergen Buscher, Young-Jae Cho, Amanda Corley, Arne Diehl, Eileen Gilder, Stephan M. Jakob, Hyung-Sook Kim, Bianca J. Levkovich, Sung Yoon Lim, Shay McGuinness, Rachael Parke, Vincent Pellegrino, Yok-Ai Que, Claire Reynolds, Sam Rudham, Steven C. Wallis, Susan A. Welch, David Zacharias, John F. Fraser, Kiran Shekar, Jason A. Roberts
Abstract
were 3.20 liters/h and 29.7 liters respectively, while the clearance for patients on RRT was 0.15 liters/h. ECMO variables did not improve the final covariate model. We found that recommended dosing regimens for critically ill adult patients not on ECMO can be safely and effectively used in those on ECMO. Loading doses of at least 25 mg/kg followed by maintenance doses of 12.5-20 mg/kg every 12 h are associated with a 97-98% probability of efficacy and 11-12% probability of toxicity, in patients with normal renal function. Therapeutic drug monitoring along with reductions in dosing are warranted for patients with renal impairment and those with concomitant RRT. (This study is registered with the Australian New Zealand Clinical Trials Registry [ANZCTR] under number ACTRN12612000559819.).