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| 지속적 동정맥 혈액여과시 Amikacin 제거에 관한 연구 |
| 신재국 , 장인진 , 신상구 , 한진석 , 엄재호 , 김성권 , 이정상 |
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| Abstract |
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The effect of continuous arteriovenous hemofiltration (CAVH) on the kinetics of amikacin was studied in seven renal failure patients undergoing continuous arter- iovenous hemofiltration. Pharmacokinetic parameters in each patient were estimated by simultaneous measur- ement of peak amikacin levels of arterial, venous plas- ma and filtrate samples, and trough arterial drug level. Average clearance of amikacin by CAVH (ultra- filtrate flow rate: 6.13-8.43 ml/min) was 7.01±0.85 ml/ min, which corresponded to the 55.9% of total clearance during homofiltration. The sieving coefficient was 0. 910.11 in the hemofiltration system of Garbro AVH kit 55. Volume of distribution of amikacin was estimat- ed to be 0.32±0.07 L/kg lean body weight. The half-life of amikacin in each renal failure patient was significantly reduced by hemofiltration from 77.6±9.4 hr to 21.0±9.4 hr. The fraction of amikacin removed by 24 hour CAVH was estimated to be 35.9±7.7%. The present results suggest that supplement dose and close monitoring of plasma amikacin concentration is necessary for optimum amikacin therapy during CAVH, especially in condition changing the flow rate of filtra- tion. |
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