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Effect of cardiopulmonary bypass on cefazolin disposition
Author(s) -
Miller Kenneth W,
McCoy Harry G,
Chan Keith K H,
Fischer Ronald P,
Lindsay William G,
Seifert Randall D,
Zaske Darwin E
Publication year - 1980
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1980.78
Subject(s) - cefazolin , cardiopulmonary bypass , disposition , medicine , anesthesia , chemistry , antibiotics , psychology , social psychology , biochemistry
Cefazolin kinetics was studied in 8 patients the day before (PREOP), during (SURG), and the day after (POSTOP) cardiopulmonary bypass (CPB) surgery. PREOP (48.6 ml/min) and POSTOP (46.6 ml/min) total body clearances were of the same order and both were greater than the SURG (27.4 ml/min) total body clearance. Since cefazolin is almost entirely eliminated by the kidney, the lower SURG clearance is a result of reduced renal elimination, as confirmed by measuring cefazolin SURG (28.7 ml/min) and POSTOP (52.9 ml/min) renal clearance. The reduction in cefazolin renal elimination was the same throughout the surgical procedure, including the period of extracorporeal circulation. Cefazolin distribution was altered by the operative procedure as evidenced by a higher SURG steady‐state volume of distribution. This increase in apparent cefazolin distribution volume brought about by surgery was not seen with cephalothin, which was investigated by us in a similar group of patients. The different effect of CPB surgery on cefazolin and cephalothin distribution may be due to differences in plasma protein binding. Clinical Pharmacology and Therapeutics (1980) 27, 550–556; doi: 10.1038/clpt.1980.78