Vancomycin plasma concentrations in cardiac surgery with the use of profound hypothermic circulatory arrest.
OBJECTIVE
This study was undertaken to compare the effect of deep hypothermic circulatory arrest, compared with moderate hypothermia, on the plasma concentrations and pharmacokinetic profile of vancomycin, administered as prophylaxis, in patients undergoing cardiac surgery with cardiopulmonary bypass.


METHODS
Two groups of adult cardiac surgery patients were prospectively studied. One group consisted of 12 patients undergoing valvular surgery with moderate hypothermia, and another group was of 12 patients undergoing surgery with the use of profound hypothermic circulatory arrest. Vancomycin was administered before skin incision, and plasma levels were measured at regular intervals for 24h.


RESULTS
The plasma concentrations of vancomycin showed a similar pattern in both groups. The pharmacokinetic profile showed a three-compartment model in both groups.


CONCLUSIONS
The dosing of vancomycin, if used as antibiotic prophylaxis, does not need to be adjusted in cardiac surgery patients when undergoing profound hypothermic circulatory arrest, since the plasma concentrations and pharmacokinetic profile are similar to patients with moderate hypothermia. The pharmacokinetic profile, consisting of three compartments, was not changed by the differences in temperature.
van der Starre
Pieter J A
PJ
Department of Anesthesia, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA. pieterva@stanford.edu
Kolz
Matthew
M
Lemmens
Harry J M
HJ
Faix
James D
JD
Mitchell
Scott
S
Miller
Craig
C
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000097:blood*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D050792:Circulatory Arrest, Deep Hypothermia Induced; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000097:blood / Q000517:prevention & control; D014640:Vancomycin / Q000097:blood*
D000900:Anti-Bacterial Agents; D014640:Vancomycin