caa a22 4500 475819233 CHVBK 20180406123818.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1007/s002280000216 doi (NATIONALLICENCE)springer-10.1007/s002280000216 Influence of continuous veno-venous haemodiafiltration and continuous veno-venous haemofiltration on the pharmacokinetics of fluconazole [Elektronische Daten] [E. Muhl, T. Martens, H. Iven, P. Rob, H.-P. Bruch] Abstract.: Objective: To compare the elimination of fluconazole by continuous veno-venous haemodiafiltration (CVVHD) and continuous veno-venous haemofiltration (CVVH) at different dosages. Intervention: Patients received doses of 400mg (n=3), 600mg (n=1) or 800mg (n=2) fluconazole as a short-time infusion once a day. Patients underwent CVVHD the first day and CVVH the second day. CVVHD and CVVH were performed using an acrylonitrile hollow-fibre filter at a constant blood flow of 90ml/min and a substitution flow of 1000ml/h (predilution). During CVVHD, the dialysate flow was 1000ml/h. Ultrafiltration rates were 1158±90.5ml/h during CVVHD and 1167±81.6ml/h. Serum and ultrafiltrate/dialysate concentrations of fluconazole were determined on nine occasions over 24h. Participants: Six critically ill patients with acute renal failure (ARF) and serious fungal infection. Results: Extracorporeal clearance (CVVHD 30.5±6.0ml/min, CVVH 17.5±4.0ml/min) and total clearance of fluconazole (CVVHD 37.9±4.4ml/min, CVVH 25.3±6.5ml/min) were significantly higher during CVVHD (P<0.05). During CVVHD, the sieving coefficient (SCVVHD) was 0.88 (range 0.54-1) and the elimination half-life (t 1/2) was 14.8-35.1h. During CVVH, the SCVVH was 0.96 (range 0.56-1.02) and t 1/2 was 24.0-51.6h. Conclusions: A daily dosage of 400-800mg fluconazole is recommended in the treatment of life-threatening fungal infections in critically ill patients undergoing CVVHD since the clearance of CVVHD may considerably exceed the clearance in patients with normal renal function, which is about 20ml/min. Drug monitoring is highly recommended for these patients. Springer-Verlag, 2000 Haemofiltration Haemodiafiltration Fluconazole nationallicence Muhl E. Department of Surgery, Medical University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany aut Martens T. Department of Surgery, Medical University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany aut Iven H. Department of Pharmacology, Luebeck Medical University, Germany aut Rob P. Department of Nephrology, Luebeck Medical University, Germany aut Bruch H.-P Department of Surgery, Medical University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany aut European Journal of Clinical Pharmacology Springer-Verlag 56/9-10(2000-12-01), 671-678 0031-6970 56:9-10<671 2000 56 228 https://doi.org/10.1007/s002280000216 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002280000216 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Muhl E. Department of Surgery, Medical University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany aut NATIONALLICENCE 700 1- Martens T. Department of Surgery, Medical University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany aut NATIONALLICENCE 700 1- Iven H. Department of Pharmacology, Luebeck Medical University, Germany aut NATIONALLICENCE 700 1- Rob P. Department of Nephrology, Luebeck Medical University, Germany aut NATIONALLICENCE 700 1- Bruch H.-P Department of Surgery, Medical University of Luebeck, Ratzeburger Allee 160, D-23538 Luebeck, Germany aut NATIONALLICENCE 773 0- European Journal of Clinical Pharmacology Springer-Verlag 56/9-10(2000-12-01), 671-678 0031-6970 56:9-10<671 2000 56 228 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer