In vitro analysis of factors affecting the continuous hemodiafiltration clearance of teicoplanin
In vitro analysis of factors affecting the continuous hemodiafiltration clearance of teicoplanin
复制标题
影响替考拉宁连续血液透析滤过清除率因素的体外分析
DOI：
10.1111/aor.14447
复制
发表时间：
2022
影响因子：
2.4
通讯作者：
Ishii Itsuko
中科院分区：
文献类型：
--
作者：
Sawada Mifuyu;Uchida Masashi;Yamazaki Shingo;Suzuki Tatsuya;Suzuki Takaaki;Ishii Itsuko
背景：在脓毒症的治疗中，持续血液滤过（CHDF）和抗生素（如替柯planin (TEIC)）的使用经常同时进行。采用聚甲基丙烯酸甲酯（PMMA）膜或聚乙烯亚胺（AN69ST）包覆的聚丙烯腈-甲基磺酸钠共聚物膜，研究影响TEIC中CHDF清除（CLCHDF）的因素。我们还研究了TEIC在血液过滤器上的吸附是否会抑制白细胞介素（IL）‐6在膜上的吸附。方法将steic、人血清白蛋白（HSA）和IL - 6与血液滤膜片孵育，计算吸附率。采用体外CHDF电路模型计算TEIC的CLCHDF、滤过率和吸附率。结果TEIC在PMMA和AN69ST膜片上的吸附率分别为15.0% ~ 100%和- 10% ~ 5%。添加或不添加TEIC时，IL - 6的吸附率相似。在PMMA - CHDF下，clchdf和TEIC的吸附率与HSA有关，而与流出流量（Qe）无关。clchdfand69st‐CHDF依赖于HSA和Qe。AN69ST‐CHDF下观察到的clchdf与预测值（Qe和等离子体未结合分数的乘积）相似。PMMA - CHDF下的clchdf值是预测值的2.0-7.8倍。结论PMMA膜对TEIC clchdf的影响主要是吸附作用，而AN69ST膜对TEIC clchdf的影响主要是滤过作用。TEIC吸附不影响IL - 6在PMMA膜上的吸附。
BackgroundIn the treatment of sepsis, continuous hemodiafiltration (CHDF) and the administration of antibiotics such as teicoplanin (TEIC) are frequently performed in parallel. We aimed to clarify the factors influencing the CHDF clearance (CLCHDF) of TEIC using a polymethylmethacrylate (PMMA) membrane or a polyacrylonitrile and sodium methallyl sulfonate copolymer membrane coated with polyethylenimine (AN69ST). We also investigated whether the adsorption of TEIC onto the hemofilters inhibits the adsorption of interleukin (IL)‐6 onto the membranes.MethodsTEIC, human serum albumin (HSA), and IL‐6 were incubated with pieces of hemofilter membranes and adsorption rates were calculated. The CLCHDF, diafiltration rate, and adsorption rate of TEIC were calculated using an in vitro CHDF circuit model.ResultsThe adsorption rates of TEIC onto the pieces of PMMA and AN69ST membranes ranged from 15.0% to 100% and from −10% to 5%, respectively. The adsorption rate of IL‐6 was similar with or without TEIC. The CLCHDFand adsorption rate of TEIC under PMMA‐CHDF depended on HSA, but not on effluent flow rate (Qe). The CLCHDFunder AN69ST‐CHDF depended on HSA and Qe. The observed CLCHDFunder AN69ST‐CHDF was similar to the predicted value (the product of Qe and the plasma unbound fraction). The observed CLCHDFunder PMMA‐CHDF was 2.0–7.8 times greater than the predicted value.ConclusionsAdsorption mainly contributes to the CLCHDFof TEIC using PMMA membranes, whereas diafiltration mainly contributes to the CLCHDFof TEIC using AN69ST membranes. TEIC adsorption might not affect the adsorption of IL‐6 onto PMMA membrane.