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Frontiers in Bioscience-Scholar (FBS) is published by IMR Press from Volume 13 Issue 1 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

1 Jan 2016Review

Drug dosage in continuous venoveno hemofiltration in critically ill children

Farahnak Assadi 1,*, Fatemeh Ghane Shahrbaf 2
Affiliations
Article Info

1 Department of Pediatrics, Section of Nephrology, Rush University Medical Center, Chicago, 445 E. North Water Street, Chicago, Illinois, USA 60611, M.D

2 Department of Pediatrics, Section of Nephrology, Mashhad University of Medical Sciences, Dr. Shiekh Children’s Hospital, Mashahd, Iran

*Author to whom correspondence should be addressed.

 

Abstract

The dosage of drugs in patients requiring continuous renal replacement therapy need to be adjusted based on a number of variables that that affect pharmacokinetics (PK) including patient weight, CRRT modality (convention, vs. diffusion), blood and/or effluent flow, hemofilter characteristics, physiochemical drug properties, volume of distribution, protein binding and half-life as well as residual renal function. There is a paucity of data on PK studies in children with acute kidney injury requiring CRRT. When possible, therapeutic drug monitoring should be utilized for those medications where serum drug concentrations can be obtained in a clinically relevant time frame. Also, a patient-centered team approach that includes an intensive care unit pharmacist is recommended to prevent medication-related errors and enhance safe and effective medication use is highly recommended. The aim of this article is to review the current guidelines for drug dosing in critically ill children who require continuous venovenous hemofiltration.

Keywords

  • Continuous venovenous hemofiltration
  • acute kidney injury
  • Critically ill children
  • Drug dosing Adjustment
  • Review

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