title: Ketamine and midazolam kinetics during continuous hemodiafiltration in patients with multiple organ dysfunction syndrome.
abstract: OBJECTIVE
  To assess the effect of continuous hemodiafiltration (CHDF) on ketamine and midazolam kinetics in multiple organ dysfunction syndrome (MODS).
  
  
  METHODS
  Consecutive clinical study in a general intensive care unit of a university hospital.
  
  
  METHODS
  Twelve adult patients with MODS requiring CHDF.
  
  
  RESULTS
  A total of 68 samples were collected during CHDF for ketamine, norketamine, and midazolam assays. The clearance values for ketamine and norketamine were 10.8 +/- 6.6 and 10.9 +/- 11.5 ml/min and their daily extractions were 21.4 +/- 7.1 and 10.2 +/- 11.5 mg/day, respectively. Midazolam was not eliminated through the filter during CHDF. There were no changes in Ramsay Sedation Score or Glasgow Coma Scale during CHDF.
  
  
  CONCLUSIONS
  Small fractions of ketamine and norketamine were eliminated during CHDF in MODS. Midazolam was not eliminated during CHDF. CHDF did not affect the sedation using ketamine and midazolam even in MODS patients.
authors.affiliation: Department of Anesthesiology, University of Hirosaki, School of Medicine, Japan. tsubo@cc.hirosaki-u.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Tsubo
authors.forename: I
authors.initials: I
authors.lastname: Sakai
authors.forename: H
authors.initials: H
authors.lastname: Okawa
authors.forename: H
authors.initials: H
authors.lastname: Ishihara
authors.forename: A
authors.initials: A
authors.lastname: Matsuki
mesh_terms: D000700:Analgesics / Q000097:blood / Q000493:pharmacokinetics*; D014151:Anti-Anxiety Agents / Q000097:blood / Q000493:pharmacokinetics*; D005260:Female; D015600:Glasgow Coma Scale; D017583:Hemodiafiltration; D006801:Humans; D007649:Ketamine / Q000097:blood / Q000493:pharmacokinetics*; D008297:Male; D008657:Metabolic Clearance Rate; D008874:Midazolam / Q000097:blood / Q000493:pharmacokinetics*; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000378:metabolism* / Q000628:therapy
chemical_list: D000700:Analgesics; D014151:Anti-Anxiety Agents; D007649:Ketamine; D008874:Midazolam