Determination of polymyxin B concentration in plasma and its application in critically ill patients / 中国药房
China Pharmacy
; (12): 704-709, 2023.
Article
em Zh
| WPRIM
| ID: wpr-965509
Biblioteca responsável:
WPRO
ABSTRACT
OBJECTIVE To establish a method for the determination of polymyxin B concentration in plasma and apply it to clinical practice. METHODS After precipitated with 5% trichloroacetic acid solution, using polymyxin E2 as internal standard, the concentrations of polymyxin B1 and B2 in plasma sample were determined by UPLC-MS/MS. The determination was performed on BEH C18 chromatographic column with water (0.1% formic acid)-acetonitrile (0.1% formic acid) as mobile phase (gradient elution) at the flow rate of 0.5 mL/min. The sample size was 10 µL. The detection was accomplished with electrospray ionization operated in positive ion scanning by multi-reaction monitoring mode. The ion pairs for quantitative analysis were m/z 603.2→101.2 (polymyxin B1), m/z 595.7→101.1 (polymyxin B2) and m/z 578.5→101.1 (internal standard). The plasma concentration of polymyxin B in 79 critically ill patients was measured by the above method, the occurrence of acute renal injury (AKI) was recorded and the relationship of polymyxin B concentration in plasma with AKI was analyzed. RESULTS The linear ranges of polymyxin B1 and polymyxin B2 were 200-20 000, 50-5 000 ng/mL (r>0.995), and the lower limits of quantification were 200 and 50 ng/mL, respectively. RSDs of intra‐day and inter‐day precision tests were not higher than 12.06%, the average extraction recovery was 103.04%-117.44%, and RSDs of matrix effect test and stability test were all not higher than 7.42%. Steady state trough and peak plasma concentration were (2.54±2.52) and (8.17±5.20) mg/L for 79 clinical patients using polymyxin B. Eighteen patients out of 27 included patients developed AKI, with an incidence of 66.67%. The peak concentration of polymyxin B of patients without AKI was significantly lower than that of patients with AKI (P<0.05), but there was no significant difference in the trough concentration between two groups (P>0.05). CONCLUSIONS The established UPLC-MS/MS has the advantages of simple operation and high sensitivity, and can be used to monitor the plasma concentration of polymyxin B in patients. The occurrence of AKI is correlated with the peak concentration of polymyxin B.
Texto completo:
1
Base de dados:
WPRIM
Idioma:
Zh
Revista:
China Pharmacy
Ano de publicação:
2023
Tipo de documento:
Article