Copyright
©The Author(s) 2018.
World J Cardiol. Nov 26, 2018; 10(11): 234-241
Published online Nov 26, 2018. doi: 10.4330/wjc.v10.i11.234
Published online Nov 26, 2018. doi: 10.4330/wjc.v10.i11.234
Table 1 Patients’ characteristics n (%)
Characteristics | |
Patients | 236 |
Age, median (range) | 70 (25-86) |
Male gender | 149 (63) |
BMI, kg/m2, median (range) | 26 (18-40) |
Diabetes | 46 (19) |
COPD | 0 |
Hypertension | 151 (64) |
Smoke | 28 (12) |
Surgical time, min, median (range) | 249 (119-593) |
Surgical procedure | |
CABG | 72 (30.5) |
Valve | 113 (47.9) |
CABG+Valve | 34 (14.4) |
Other1 | 17 (7.2) |
Off-pump CABG | 21 (8.9) |
Left IMA | 53 (22.4) |
Both IMA | 17 (7.2) |
EUROscore add, median (range) | 5 (1-6) |
EUROscore log, median (range) | 4.8 (1-7.74) |
Mechanical ventilation, d, median (range) | 7 (2-912) |
ICU stay, d, median (range) | 1 (1-24) |
RBC transfusions, n, median (range) | 2 (0-9) |
Table 2 Pharmacokinetic comparison between patients with at least 1 serum sample with a vancomycin concentration <10 mg/L (in the left column) and patients without serum samples with a vancomycin concentration <10 mg/L (in the right column)
Vancomycin levels < 10 mg/L (n = 114) | Vancomycin levels ≥ 10 mg/L (n = 122) | P-value | |
Cmax (mg/L) | 33.2 (6.2-122.0) | 57.9 (14.6-210.0) | <0.001 |
AUC (mg*h/L) | 119.2 (28.3-247.7) | 191.7 (95.8-467.8) | <0.001 |
t1/2 (h) | 3.9 (1.6-9.2) | 4.0 (1.3-9.8) | 0.437 |
CL (L/h) | 8.4 (4.0-35.3) | 5.2 (2.1-10.4) | <0.001 |
Vd (L) | 47.2 (16.5-195.2) | 29.8 (12.4-63.3) | <0.001 |
Table 3 Risk factors for vancomycin levels under 10 mg/L - univariate binary logistic model
OR | 95%CI | P-value | |
CPB (off-pump vs on-pump) | 0.51 | 0.20-1.30 | 0.156 |
Vancomycin infusion (stopped vs non-stopped) | 0.6 | 0.17-2.10 | 0.421 |
Age at surgery (> 70 yr vs ≤ 70 yr) | 0.54 | 0.32-0.92 | 0.021 |
Gender (Female vs male) | 0.44 | 0.26-0.76 | 0.003 |
BMI (> 25 vs ≤ 25) | 2.3 | 1.36-3.88 | 0.002 |
Fluid balance (> 2000 mL vs ≤ 2000 mL) | 1.44 | 0.86-2.41 | 0.163 |
CrCl (> 70 mL/min vs ≤ 70 mL/min) | 2.56 | 1.51-4.34 | <0.001 |
Vancomycin dosage (> 15 mg/kg vs ≤ 15 mg/kg) | 0.38 | 0.21-0.66 | 0.001 |
Vancomycin infusion duration | 0.237 | ||
50-59 min vs < 50 min | 0.5 | 0.21-1.21 | 0.123 |
60 min vs < 50 min | 0.63 | 0.28-1.42 | 0.26 |
61-70 min vs < 50 min | 0.48 | 0.14-1.69 | 0.254 |
> 70 min vs < 50 min | 1.2 | 0.44-3.31 | 0.719 |
Table 4 Risk factors for vancomycin levels under 10 mg/L - multivariate binary logistic model
OR | 95%CI | P-value | |
Age at surgery (>70 yr vs ≤ 70 yr) | 0.69 | 0.36-1.28 | 0.245 |
Gender (Female vs male) | 0.54 | 0.30-0.97 | 0.039 |
BMI (> 25 vs ≤ 25) | 1.99 | 1.15-3.45 | 0.015 |
CrCl (> 70 mL/min vs ≤ 70 mL/min) | 1.92 | 1.09-3.40 | 0.024 |
Vancomycin dosage (>15 mg/kg vs ≤ 15 mg/kg) | 0.75 | 0.36-1.57 | 0.451 |
- Citation: Cotogni P, Barbero C, Rinaldi M. Incidence and risk factors for potentially suboptimal serum concentrations of vancomycin during cardiac surgery. World J Cardiol 2018; 10(11): 234-241
- URL: https://www.wjgnet.com/1949-8462/full/v10/i11/234.htm
- DOI: https://dx.doi.org/10.4330/wjc.v10.i11.234