TY - JOUR A1 - Scharf, Christina A1 - Weinelt, Ferdinand Anton A1 - Schroeder, Ines A1 - Paal, Michael A1 - Weigand, Michael A1 - Zoller, Michael A1 - Irlbeck, Michael A1 - Kloft, Charlotte A1 - Briegel, Josef A1 - Liebchen, Uwe T1 - Does the cytokine adsorber CytoSorb (R) reduce vancomycin exposure in critically ill patients with sepsis or septic shock? BT - a prospective observational study JF - Annals of intensive care N2 - Background: Hemadsorption of cytokines is used in critically ill patients with sepsis or septic shock. Concerns have been raised that the cytokine adsorber CytoSorb (R) unintentionally adsorbs vancomycin. This study aimed to quantify vancomycin elimination by CytoSorb (R) . Methods: Critically ill patients with sepsis or septic shock receiving continuous renal replacement therapy and CytoSorb (R) treatment during a prospective observational study were included in the analysis. Vancomycin pharmacokinetics was characterized using population pharmacokinetic modeling. Adsorption of vancomycin by the CytoSorb (R) was investigated as linear or saturable process. The final model was used to derive dosing recommendations based on stochastic simulations. Results: 20 CytoSorb (R) treatments in 7 patients (160 serum samples/24 during CytoSorb (R)-treatment, all continuous infusion) were included in the study. A classical one-compartment model, including effluent flow rate of the continuous hemodialysis as linear covariate on clearance, best described the measured concentrations (without CytoSorb (R)). Significant adsorption with a linear decrease during CytoSorb (R) treatment was identified (p <0.0001) and revealed a maximum increase in vancomycin clearance of 291% (initially after CytoSorb (R) installation) and a maximum adsorption capacity of 572 mg. For a representative patient of our cohort a reduction of the area under the curve (AUC) by 93 mg/L*24 h during CytoSorb (R) treatment was observed. The additional administration of 500 mg vancomycin over 2 h during CytoSorb (R) attenuated the effect and revealed a negligible reduction of the AUC by 4 mg/L*24h. Conclusion: We recommend the infusion of 500 mg vancomycin over 2 h during CytoSorb (R) treatment to avoid subtherapeutic concentrations. KW - Vancomycin KW - Critically ill patients KW - CytoSorb (R) KW - Sepsis; KW - Pharmacokinetics KW - Adsorption Y1 - 2022 U6 - https://doi.org/10.1186/s13613-022-01017-5 SN - 2110-5820 VL - 12 IS - 1 PB - Springer CY - Heidelberg ER - TY - JOUR A1 - Corbett, Tim A1 - Siegel, Björn A1 - Thulin, Mirjam A1 - Csáky, Moritz A1 - Hödl, Klaus A1 - Kasper-Marienberg, Verena A1 - Berkovich, Ilya A1 - Czakai, Johannes A1 - Maślak-Maciejewska, Alicja A1 - Stechauner, Martin A1 - Dodou, Lida-Maria A1 - Heimann-Jelinek, Felicitas A1 - Nasr, Omar T. A1 - Halbinger, Monika A1 - Jánošíková, Magdaléna A1 - Keßler, Katrin A1 - Kauders, Anthony D. A1 - Piskačová, Zora A1 - Arnold, Rafael D. A1 - Schulz, Michael K. A1 - Shapira, Elena A1 - Sidky, Sean A1 - Sun, Cheuk Him Ryan A1 - Tirosh-Samuelson, Hava A1 - Tusan, Michelle A1 - Weigand, Susanne ED - Siegel, Björn ED - Thulin, Mirjam ED - Corbett, Tim ED - Czendze, Oskar T1 - Intersections between Jewish Studies and Habsburg Studies T2 - PaRDeS : Journal of the Association for Jewish Studies in Germany T2 - PaRDeS : Zeitschrift der Vereinigung für Jüdische Studien e. V. N2 - In the aftermath of the Shoah and the ostensible triumph of nationalism, it became common in historiography to relegate Jews to the position of the “eternal other” in a series of binaries: Christian/Jewish, Gentile/Jewish, European/Jewish, non-Jewish/Jewish, and so forth. For the longest time, these binaries remained characteristic of Jewish historiography, including in the Central European context. Assuming instead, as the more recent approaches in Habsburg studies do, that pluriculturalism was the basis of common experience in formerly Habsburg Central Europe, and accepting that no single “majority culture” existed, but rather hegemonies were imposed in certain contexts, then the often used binaries are misleading and conceal the complex and sometimes even paradoxical conditions that shaped Jewish life in the region before the Shoah. The very complexity of Habsburg Central Europe both in synchronic and diachronic perspective precludes any singular historical narrative of “Habsburg Jewry,” and it is not the intention of this volume to offer an overview of “Habsburg Jewish history.” The selected articles in this volume illustrate instead how important it is to reevaluate categories, deconstruct historical narratives, and reconceptualize implemented approaches in specific geographic, temporal, and cultural contexts in order to gain a better understanding of the complex and pluricultural history of the Habsburg Empire and the region as a whole. T3 - PaRDeS : Zeitschrift der Vereinigung für Jüdische Studien e.V. - 29 KW - Habsburg Studies KW - Jewish Studies KW - Intersections KW - Central Europe KW - Habsburg Empire KW - Habsburgstudien KW - Jüdische Studien KW - Überschneidungen KW - Zentraleuropa KW - Habsburgisches Reich Y1 - 2024 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-622072 SN - 978-3-86956-574-3 SN - 1614-6492 SN - 1862-7684 IS - 29 PB - Universitätsverlag Potsdam CY - Potsdam ER -