Elimination of Antibiotics During Renal Replacement Therapy and Cytosorb Adsorptive Therapy

Heinrich-Heine University, Duesseldorf30 enrolled

Overview

Cytokine adsorption using the cytosorb adsorber is currently investigated to reduce the levels of proinflammatory cytokines in patients with severe sepsis and septic shock. The adsorber is frequently used in series with continuous renal replacement therapy. Up to date, no data on the removal of antibiotic drugs during combined renal replacement therapy and cytokine adsorptive therapy is available. Therefore, we want to investigate \- whether and to what extent antibiotic drugs (piperacillin/tazobactam and imipenem/cilastatin) are removed during combined continuous renal replacement therapy and cytosorb adsorption in patients with severe sepsis and septic shock

Patients in this trial are undergoing renal replacement therapy as part of their routine care. Thus, this is an observational trial.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Critical Illness Sepsis Acute Kidney Injury

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Intensive care patients with severe sepsis or septic shock and acute kidney injury requiring continuous renal replacement therapy and cytokine adsorption * Age \> 18 y Exclusion Criteria: * \< 18 y * Pregnancy * Contraindications against citrate-anticoagulation or continuous renal replacement therapy or cytokine adsorption

Outcomes

Primary Outcomes

Removal of antibiotic drugs during the first 8 hours of combined continuous renal replacement therapy and cytosorb adsorption

Removal of antibiotic drugs during combined CRRT and adsorption will be evaluated by calculating total filter clearance using the drug concentration pre- and postfilter as well as the dialysate concentration. The adsorptive clearance will be evaluated using the pre- and postadsorber concentration. The outcome measure will be removal of antibiotic drug \[mg/8 h dosing interval\].

Time frame: 8 hours