Abstract
A central venous catheter with a built‐in microdialysis membrane is available for continuous lactate and glucose monitoring in the intensive care unit (ICU). As this catheter might also be suitable for repeated measurements of unbound drug levels, we studied in vitro the feasibility of monitoring unbound antibiotic concentrations. The catheter was placed in various media at 37°C spiked with gentamicin or vancomycin. Dialysate fractions were repeatedly collected over 3 hours with a NaCl 0.9% perfusate flow of 5 μL/min. Total and unbound drug concentrations in medium and perfusate were measured by immunoassay. After 60 minutes stable recovery for both drugs was observed, with mean ±SD relative recoveries of vancomycin and gentamicin in human serum of 64% ±0.4% and 73% ±3%. The recoveries of the unbound concentrations were 91% ±3% and 91% ±4%. This intravenous microdialysis system may be a very useful platform for therapeutic drug monitoring in the ICU.
Highlights
Patients in the intensive care unit (ICU) often require the concomitant administration of several drugs
The commercially available intravenous microdialysis EIRUS® catheter has been designed for use in ICU patients to continuously monitor lactate and glucose at the bedside.[7]
We have evaluated the in vitro suitability of an intravenous microdialysis Central venous catheters (CVC) for Therapeutic drug monitoring (TDM) of vancomycin and gentamicin
Summary
Patients in the intensive care unit (ICU) often require the concomitant administration of several drugs. Therapeutic drug monitoring (TDM) is essential in these patients to optimize antimicrobial treatment.[4] To adequately assess the patients’ pharmacokinetics multiple blood samples are required, which can be distressing to the patient. The commercially available intravenous microdialysis EIRUS® catheter has been designed for use in ICU patients to continuously monitor lactate and glucose at the bedside.[7] This catheter is a standard triple-lumen intravenous catheter, which integrates a novel microdialysis function (Figure 1) which strongly reduces the need for lactate and glucose blood sampling for up to 30 days.[7] Central venous catheters (CVC) are used in the majority of ICU patients. We hypothesized that an intravenous microdialysis catheter may serve as an ideal platform for repeated measurements of the circulating unbound concentrations of many drugs. The aim of this study was to investigate the usability of intravenous microdialysis for TDM of vancomycin and gentamicin in an in vitro setting
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