Clearance of vancomycin during high-volume haemofiltration: impact of pre-dilution

Abstract

OBJECTIVE: To measure the sieving coefficient (SC) and clearance of vancomycin during high-volume haemofiltration (HVHF) and to evaluate the impact of different pre-dilution regimens on these variables. DESIGN AND SETTING: Prospective interventional study in the intensive care unit in a tertiary university hospital. PATIENTS: Seven patients with septic shock and multi-organ dysfunction. INTERVENTIONS: HVHF (6 l/h fluid exchange) was performed in septic shock patients using variable proportions of their replacement fluid in pre- and post-dilution mode. MEASUREMENTS AND RESULTS: Pre-filter, post-filter and ultrafiltrate vancomycin concentrations were measured simultaneously, and SC and clearan..