[Study on CAZ levels in serum, urine and myocardial tissue during and after open-heart surgery with cardiopulmonary bypass].
Ceftazidime (CAZ) was administered to 10 patients who underwent open heart surgery using an artificial heart and lung (AHL), and the concentrations of the drug in the blood, urine, filtrate and cardiac muscle were measured. Following anesthesia induction, patients were injected intravenously with 2 g CAZ, and then 2 g CAZ was injected initially into the filling solution of the AHL followed by 1 g every 1 hr. After the surgery, patients received 1 g CAZ intravenously followed by the same dose every 12 hr till Day 5 of the surgery. Results obtained were as follows: 1) The concentration of CAZ in the cardiac muscle averaged 41.2 +/- 12.3 micrograms/g, and the ratio to the concentration in the plasma averaged 0.61 +/- 0.12, being considered to be reasonable. 2) The change in the mean plasma concentration of CAZ during extracorporeal circulation was maintained within the range of 109.7 to 337.0 micrograms/ml, and the concentration increased slightly with the repeated injection. In 2 cases, the plasma concentration was transiently more than 400 micrograms/ml, however, no side effect was observed. 3) The mean plasma concentration of CAZ after surgery attained 214.4 +/- 38.9 micrograms/ml, and half-time averaged 2.8 hr. 4) The excretion rates of CAZ in urine and filtrate by the termination of the extracorporeal circulation were 30.6 and 5.2%, respectively, thus the excretion of the drug in filtrate was lower than that in urine. The total excretion rate in both urine and filtrate for 6 hr after surgery was 55.3%. 5) Neither postoperative infection nor side effect were observed in all cases. CAZ is considered to be a useful antibiotics in the cardiac surgery management.
Murata
S
S
Kobayashi
A
A
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002442:Ceftazidime / Q000097:blood / Q000493:pharmacokinetics* / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*
D002442:Ceftazidime