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Title: Vancomycin and Gentamicin Removal with the HA380 Cartridge during Experimental Hemoadsorption.
Austin Authors: Furukawa, Taku;Lankadeva, Yugeesh;Baldwin, Ian Charles;Ow, Pei Chen Connie;Hood, Sally;May, Clive;Bellomo, Rinaldo 
Affiliation: The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.
Intensive Care
Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia.;Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
Issue Date: 19-Oct-2023
Date: 2023
Publication information: Blood Purification 2023, 52(11-12)
Abstract: Hemoadsorption has emerged as an adjunctive therapy for sepsis, but its impact on antibiotic levels remains poorly defined. We conducted an in vivo experimental study to investigate the removal of vancomycin and gentamicin during hemoadsorption using the HA380 cartridge, a novel styrene-divinylbenzene copolymer cartridge. Six surgically prepared sheep were administered 2 g of vancomycin and 400 mg of gentamicin over 30 min, followed by a continuous infusion of vancomycin (20 mg/h). Hemoadsorption was implemented with a styrene-divinylbenzene copolymer HA380 cartridge at a blood flow of 120 mL/min. The removal ratio, sorbent-based clearance, and the mass removal rate were calculated for each time point. The mean 10-min vancomycin removal ratio exceeded 90% and declined to 68.0% at 30 min; 52.8% at 60 min, and 28.0% by 4 h. Due to constant plasma flow, clearance varied proportionally with the removal ratio. Over 4 hours, the total mass removal was 556 mg (SD 106.3). For gentamicin, the mean 10-min removal ratio was 96.9% and the final ratio at 4 h remained 53.0%, with clearances changing proportionately. The total mass removal of gentamicin was 138 mg (SD 26.6) over 4 h. The sorbent-based clearance of vancomycin was significantly lower than that of gentamicin (Pgroup < 0.0001). The novel HA380 sorbent cartridge appears safe and achieves significant vancomycin and gentamicin removal over a four-hour period. This information can be used by clinicians to guide their prescription and consider the additional dosing of at least an extra 25-35% amount in patients receiving HA380 hemoadsorption therapy during sepsis.
DOI: 10.1159/000534108
Journal: Blood Purification
Start page: 1
End page: 8
PubMed URL: 37857261
ISSN: 1421-9735
Type: Journal Article
Subjects: Antibiotics
HA380 Jafron cartridge
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