ArticleIntensive care medicine2006
Discrepancies between observed and predicted continuous venovenous hemofiltration removal of antimicrobial agents in critically ill patients and the effects on dosing.
Article in Intensive care medicine, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 69 citations in OpenAlex.
- High-volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial.Intensive care medicine · 2013Trial
- Impact of adsorptive CRRT membranes on vancomycin pharmacokinetics in critically ill patients.Renal failure · 2026Review
- The impact of an ex vivo paediatric renal replacement therapy circuit on antimicrobial concentrations.The Journal of antimicrobial chemotherapy · 2026Article
- Population Pharmacokinetic and Pharmacodynamic Analysis of Imipenem in Critically Ill Patients Receiving Continuous Renal Replacement Therapy.Drug design, development and therapy · 2026Article
- Exploring determinants in deciding the optimal antimicrobial dose in patients undergoing CRRT: a mixed-methods study.Antimicrobial agents and chemotherapy · 2025Article
- Invasive candidiasis: current clinical challenges and unmet needs in adult populations.The Journal of antimicrobial chemotherapy · 2023Review
- Article
- Recommendation of Antimicrobial Dosing Optimization During Continuous Renal Replacement Therapy.Frontiers in pharmacology · 2020Review
- Pharmacokinetics and Pharmacodynamics of Anti-infective Agents during Continuous Veno-venous Hemofiltration in Critically Ill Patients: Lessons Learned from an Ancillary Study of the IVOIRE Trial.Journal of translational internal medicine · 2019Article
- A Guide to Understanding Antimicrobial Drug Dosing in Critically Ill Patients on Renal Replacement Therapy.Antimicrobial agents and chemotherapy · 2019Review
- Pharmacokinetics-pharmacodynamics issues relevant for the clinical use of beta-lactam antibiotics in critically ill patients.Critical care (London, England) · 2018Review
- Article
- Article
- Vancomycin therapy in critically ill patients on continuous renal replacement therapy; are we doing enough?Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2015Article
- Does Beta-lactam Pharmacokinetic Variability in Critically Ill Patients Justify Therapeutic Drug Monitoring? A Systematic Review.Annals of intensive care · 2012Article
- Presence and accuracy of drug dosage recommendations for continuous renal replacement therapy in tertiary drug information references.The Canadian journal of hospital pharmacy · 2012Article
- Proposal of a pharmacokinetically optimized dosage regimen of antibiotics in patients receiving continuous hemodiafiltration.Antimicrobial agents and chemotherapy · 2011Article
- Antibiotic dosing in critically ill patients with acute kidney injury.Nature reviews. Nephrology · 2011Review
- Continuous-infusion beta-lactam antibiotics during continuous venovenous hemofiltration for the treatment of resistant gram-negative bacteria.The Annals of pharmacotherapy · 2009Review
- Renal replacement therapies: physiological review.Intensive care medicine · 2008Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDrug dosing during continuous venovenous hemofiltration (CVVH) is based partly upon the CVVH clearance (Cl(CVVH)) of the drug. Cl(CVVH) is the product of the sieving coefficient (SC) and ultrafiltration rate (Q(uf)). Although it has been suggested that the SC can be replaced by the fraction of a drug not bound to protein (F(up)), the F(up) values as reported in the literature may not reflect the protein binding in critically ill patients with renal failure. We compared the observed Cl(CVVH) (SC x Q(uf)) with the estimated Cl(CVVH) (estimated F(UP) x Q(uf)) and determined the effect on the maintenance dose multiplication factor (MDMF). DESIGN AND
settingClinical study in a mixed ICU in a university hospital. PATIENTS: 45 oligoanuric patients on CVVH (2 l/h).
interventionsTimed blood and ultrafiltrate samples. MEASUREMENTS AND
resultsAmoxicillin, ceftazidime, ciprofloxacin, fluconazole, metronidazole, and vancomycin were easily filtered (mean SC > 0.7) but not flucloxacillin (mean SC 0.3). Predicted and observed Cl(CVVH) corresponded only for fluconazole and metronidazole. The difference between observed and predicted MDMF was small for all drugs, with the exception of ceftazidime (mean 0.25, 95% CI -0.96 to 1.48) and vancomycin (0.05, -1.34 to 1.45). However, this difference was clinically relevant only for vancomycin, because of its narrow therapeutic index.
conclusionsDosing based on predicted CVVH removal provides an as reliable estimate than that based on observed CVVH removal except for those antibiotics that have both a narrow therapeutic index and a predominantly renal clearance (e.g., vancomycin).
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