Gentamicin pharmacokinetics in term newborn infants receiving high-frequency oscillatory ventilation or conventional mechanical ventilation: a case-controlled study

ABSTRACT OBJECTIVE: To compare the pharmacokinetics of gentamicin in infants receiving high-frequency oscillatory ventilation (HFOV) with infants receiving conventional mechanical

ventilation. DESIGN: A case-controlled study design was used to compare the pharmacokinetics of gentamicin in critically ill infants receiving HFOV and conventional mechanical ventilation.

Medical records of all full-term newborn infants (≥37 weeks gestational age) who received either high-frequency mechanical ventilation or conventional mechanical ventilation between 1991 and

2001 were reviewed and relevant patient demographics, renal function tests and gentamicin administration and plasma concentration data collected. Elimination rate constant, half-life,

volume of distribution and clearance for both groups were calculated using standard kinetics equations. SETTING: A tertiary care children's hospital. PATIENTS: Newborn infants, ≥37

weeks gestational age, receiving gentamicin and high-frequency mechanical ventilation or conventional mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: In total, 18 patients were

included in the conventional mechanical ventilation group and 15 in the HFOV group. The mean gentamicin dose for conventional mechanical ventilation and HFOV groups infants were 2.52±0.07

and 2.5±0.07 mg/kg/dose, respectively. Initial dosing interval was 12 hours in all of the conventional mechanical ventilation infants and 13 of the 15 HFOV infants. The dosing interval for

the remaining two HFOV infants was 18 hours. No patient in either group demonstrated oliguria. Statistical analysis using the Student _t_-test for unequal variances yielded significant

differences between the two groups with regard to elimination rate constant, half-life, volume of distribution and clearance, with a _p_ value of <0.05 for all the observations. The mean

of the highest _P_aw received by each patient in the HFOV group (19.2±4.05) was considerably higher than in the conventional mechanical ventilation group (13.4+2.23) (_p_>0.05).

CONCLUSION: Infants receiving HFOV had reduced gentamicin clearance. Full-term infants receiving HFOV should be initiated at gentamicin dosing intervals of 18 hours rather than the

traditional 12 hours recommended for this age group. Access through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS

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institutional subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS HIGH-FREQUENCY OSCILLATORY VENTILATION WITH VOLUME GUARANTEE IN INFANTS: A

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Scholar  Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Clinical Sciences, College of Pharmacy, University of Michigan, MI, USA Varsha Bhatt-Mehta Pharm D,

FCCP * Department of Pediatrics and Communicable Diseases, University of Michigan, MI, USA Varsha Bhatt-Mehta Pharm D, FCCP & Steven M Donn MD Authors * Varsha Bhatt-Mehta Pharm D, FCCP

View author publications You can also search for this author inPubMed Google Scholar * Steven M Donn MD View author publications You can also search for this author inPubMed Google Scholar

ADDITIONAL INFORMATION Presented at the 31st Critical Care Congress, San Diego, CA, January 2002 and at the 18th Conference on High Frequency Ventilation, Snowbird, UT, April 2002. RIGHTS

AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Bhatt-Mehta, V., Donn, S. Gentamicin Pharmacokinetics in Term Newborn Infants Receiving High-Frequency

Oscillatory Ventilation or Conventional Mechanical Ventilation: a Case-controlled Study. _J Perinatol_ 23, 559–562 (2003). https://doi.org/10.1038/sj.jp.7210985 Download citation *

Published: 20 October 2003 * Issue Date: 01 October 2003 * DOI: https://doi.org/10.1038/sj.jp.7210985 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this

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