Pharmacokinetics Clinical Trial
Official title:
Bioelectrical Impedance Analysis as a Bedside Tool to Estimate Volume of Distribution of Hydrophilic Antimicrobials in Critically Ill Patients
Bioelectrical impedance analysis is studied as a bedside tool to estimate capillary leak in order to guide dosing of hydrophilic antimicrobials.
Abstract Background: Recent data suggest that antimicrobial pharmacokinetics (PK) like volume
of distribution (Vd) or drug clearance (CL) is extremely altered in critically ill patients
with sepsis or septic shock due to pathophysiological alterations (e.g. influence on fluid
status). Bioelectrical impedance analysis (BIA) was recently introduced as a simple,
non-invasive, bedside technique to assess hydration status. The primary aim of the present
study was to explore the correlation between BIA parameters and Vd of hydrophilic
antimicrobial agents in critically ill patients. Furthermore, the relationship between BIA
measurements and clinical observations was evaluated.
Methods: We performed a validation study in healthy volunteers in September 2015 that
confirmed the reproducibility of BIA. Subsequently, a prospective observational study was
carried out in eligible patients treat-ed with amoxicillin/clavulanic acid, meropenem,
piperacillin/tazobactam or vancomycin, admitted at the in-tensive care unit (ICU) of the
University Hospitals Leuven from October 2015 to March 2016. BIA measurement was performed on
the same day as the collection of blood samples to calculate PK parameters of the
administered antibiotic.
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