When drugs disappear from the patient: elimination of intravenous medication by hemodiafiltration.

Full Abstract

Twenty-three hours after heart transplantation, life-threatening acute right heart failure was diagnosed in a patient requiring continuous venovenous hemodiafiltration (CVVHDF). Increasing doses of catecholamines, sedatives, and muscle relaxants administered through a central venous catheter were ineffective. However, a bolus of epinephrine injected through an alternative catheter provoked a hypertensive crisis. Thus, interference with the central venous infusion by the dialysis catheter was suspected. The catheters were changed, and hemodynamics stabilized at lower catecholamine doses. When the effects of IV drugs are inadequate in patients receiving CVVHDF, interference with adjacent catheters resulting in elimination of the drug by CVVHDF should be suspected.

Author information

Author/s: Stricker, Kay H (KH); Takala, Jukka (J); Hullin, Roger (R); Ganter, Christoph C (CC);

Affiliation: Departments of Intensive Care Medicine, Bern University Hospital and University of Bern, Inselspital, Bern, Switzerland.

Journal and publication information

Publication Type: Case Reports; Journal Article

Journal: Anesthesia and analgesia (Anesth Analg), published in United States. (Language: eng)

Reference: 2009-Nov; vol 109 (issue 5) : pp 1640-3

Dates: Created 2009/10/21; Completed 2009/11/05;

PMID: 19843802, status: MEDLINE (last retrieval date: 11/5/2009, IMS Date: )

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