A 58-year-old woman on ICU has acute kidney injury and is receiving CVVHDF. She is also receiving IV vancomycin. The pharmacist requests vancomycin le...

Question

A 58-year-old woman on ICU has acute kidney injury and is receiving CVVHDF. She is also receiving IV vancomycin. The pharmacist requests vancomycin levels to guide dosing. When should the vancomycin level be drawn relative to the CRRT circuit?

Accepted Answer

The vancomycin level should be drawn from a site NOT connected to the CRRT circuit (e.g. peripheral blood or from a separate arterial line), and ideally at a consistent time relative to the vancomycin dose (e.g. pre-dose trough); levels drawn from the CRRT circuit may be falsely low (post-filter) or unreliable

Answer

Timing relative to CRRT does not matter

Answer

Always draw from the CRRT return line

Answer

Draw from the CRRT pre-filter line only

Answer

Vancomycin levels cannot be measured during CRRT

uk-fficm MCQ (SBA): Vancomycin TDM During CRRT

A 58-year-old woman on ICU has acute kidney injury and is receiving CVVHDF. She is also receiving IV vancomycin. The pharmacist requests vancomycin levels to guide dosing. When should the vancomycin level be drawn relative to the CRRT circuit?