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      Adsorption Mass Transfer Zone of Vancomycin in Cartridges With Styrene-Divinylbenzene Sorbent

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          Abstract

          Cartridges for hemoadsorption containing styrene-divinylbenzene sorbent are used for multiple conditions, such as intoxication. The mass transfer zone comprises the extension along the longitudinal span of the cartridge where adsorption occurs. The aim of this experiment is to evaluate the mass transfer zone for vancomycin in the HA380 cartridge. The experiment was carried out twice. A saline solution with vancomycin passed through a HA380-modified cartridge at 100 ml/min in a single-pass fashion. The cartridge had four openings along its longitudinal dimension, at 3, 6, 9, and 12 cm. In both experiments, the collection of aliquots occurred at minute 4, in the four openings and pre- and post-cartridge, and an additional sample from the effluent bag at the end of each experiment. In the second experiment, an additional sampling of the same six sites occurred at minute 14. The sigmoidal shape of the curve for the mass transfer zone of vancomycin was similar to the theoretical one. In experiment one, at minute 4, vancomycin clearance was 98.75 ml/min. In experiment two, vancomycin clearance at minutes 4 and 14 was 93.76 and 93.20 ml/min, respectively. This implies an adequate and optimal design of the HA380 cartridge.

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          Therapeutic monitoring of vancomycin for serious methicillin-resistant Staphylococcus aureus infections: A revised consensus guideline and review by the American Society of Health-System Pharmacists, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists

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            Innovative approaches to optimizing the delivery of vancomycin in individual patients.

            The delivery of personalized antimicrobial therapy is a critical component in the treatment of patients with invasive infections. Vancomycin, the drug of choice for infections due to methicillin-resistant Staphylococcus aureus, requires the use of therapeutic drug monitoring (TDM) for delivery of optimal therapy. Current guidance on vancomycin TDM includes the measurement of a trough concentration as a surrogate for achieving an AUC to minimum inhibitory concentration (MIC) by broth microdilution (AUC/MICBMD) ratio≥400. Although trough-only monitoring has been widely integrated into clinical practice, there is a high degree of inter-individual variability between a measured trough concentration and the actual AUC value. The therapeutic discordance between AUC and trough may lead to suboptimal outcomes among patients with infections due to less susceptible pathogens or unnecessarily increase the probability of acute kidney injury (AKI) in others. Given the potentially narrow vancomycin AUC range for optimal effect and minimal AKI, clinicians need a "real-time" system to predict accurately the AUC with limited pharmacokinetic (PK) sampling. This article reviews two innovative approaches for calculating the vancomycin AUC in clinical practice based on one or two drug concentrations. One such approach involves the use of Bayesian computer software programs to estimate the "true" vancomycin AUC value with minimal PK sampling and provide AUC-guided dosing recommendations at the bedside. An alternative involves use of two concentrations (peak and trough) and simple analytic equations to estimate AUC values. Both approaches provide considerable improvements over the current trough-only concentration monitoring method.
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              Adsorption--from theory to practice.

              Adsorption at various interfaces has concerned scientists since the beginning of this century. This phenomenon underlies a number of extremely important processes of utilitarian significance. The technological, environmental and biological importance of adsorption can never be in doubt. Its practical applications in industry and environmental protection are of paramount importance. The adsorption of substrates is the first stage in many catalytic processes. The methods for separation of mixtures on a laboratory and on an industrial scale are increasingly based on utilising the change in concentration of components at the interface. Moreover, such vital problems as purification of water, sewages, air and soil are involved here too. On the other hand, many areas in which technological innovation has covered adsorption phenomena have been expanded more through art and craft than through science. A basic understanding of the scientific principles is far behind; in part because the study of interfaces requires extremely careful experimentation if meaningful and reproducible results are to be obtained. In recent years, however, considerable effort has been increasingly directed toward closing the gap between theory and practice. Crucial progress in theoretical description of the adsorption has been achieved, mainly through the development of new theoretical approaches formulated on a molecular level, by means of computer simulation methods and owing to new techniques which examine surface layers or interfacial regions. Moreover, during the last 15 years new classes of solid adsorbents have been developed, such as activated carbon fibres and carbon molecular sieves, fullerenes and heterofullerenes, microporous glasses and nanoporous--both carbonaceous and inorganic--materials. Nanostructured solids are very popular in science and technology and have gained extreme interest due to their sorption, catalytic, magnetic, optical and thermal properties. Although the development of adsorption up to the 1918s has been following rather a zig-zag path, this arm of surface science is now generally considered to have become a well-defined branch of physical science representing an intrinsically interdisciplinary area between chemistry, physics, biology and engineering. This review presents in brief the history of adsorption and highlights the progress in theoretical description of the phenomenon under consideration. The paper deals with the above problems critically, showing the development of adsorption, presenting some of the latest important results and giving a source of up-to-date literature on it. Moreover, in this paper the most important aspects are overviewed referring to today's trends and visions in application of adsorption science in industry, environmental protection and in environmental analysis. The relationship between development of adsorption theory and adsorption practice is pointed out. Current understanding and perspectives pertaining to applications of adsorption phenomena on laboratory and on industrial scale as well as environmental protection are discussed and illustrated by means of a few spectacular examples.
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                Author and article information

                Journal
                ASAIO J
                ASAIO J
                MAT
                Asaio Journal
                Lippincott Williams & Wilkins (Hagerstown, MD )
                1058-2916
                1538-943X
                12 February 2024
                August 2024
                : 70
                : 8
                : 714-718
                Affiliations
                From the [* ]Laboratory of Molecular Pharmacology, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
                []Fenix Nephrology, São Paulo, Brazil
                []Hospital Sírio-Libanês, São Paulo, Brazil
                [§ ]International Renal Research Institute of Vicenza (IRRIV), Vicenza, Italy
                []Department of Nephrology, Dialysis and Kidney Transplantation, San Bortolo Hospital, Vicenza, Italy
                []Department of Medicine (DIMED), Università degli Studi di Padova, Padova, Italy
                [# ]Critical Care Unit, Carlos Van Buren Hospital, Valparaíso, Chile
                [** ]Nephrology and Dialysis Unit, Carlos Van Buren Hospital, Valparaíso, Chile
                [†† ]Department of Medicine, Universidad de Valparaíso, Valparaíso, Chile.
                Author notes
                Correspondence: Thiago Reis, Laboratory of Molecular Pharmacology, Faculty of Health Sciences, University of Brasília, Asa Norte, 70910-900, Brasília, Brazil. Email: thiagoreisnefro@ 123456gmail.com ; Twitter: @NephrologistThe.
                Author information
                https://orcid.org/0000-0002-7071-117X
                https://orcid.org/0000-0002-6697-4065
                https://orcid.org/0000-0002-1696-9997
                https://orcid.org/0000-0002-3283-6297
                Article
                ASAIO-23-0627 00013
                10.1097/MAT.0000000000002166
                11280445
                38346297
                d644bef4-895b-4768-8fbe-c62e464f0983
                Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASAIO.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                : December 2023
                : January 2024
                Categories
                Renal/Extracorporeal Blood Treatment
                Custom metadata
                TRUE

                adsorption,cartridges,hemoadsorption,mass transfer zone,blood purification,vancomycin

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