Phosphodiesterase III inhibitor olprinone chlorate is not significantly removed by continuous venovenous hemodiafiltration

The study objective was to determine whether a phosphodiesterase III inhibi tor, olprinone chlorate, is effectively removed by continuous venovenous he modiafiltration (CV-VHDF) in a patient with cardiac and renal failure. The patient was a 73 year old man who had undergone coronary artery bypass graf ting for ischemic heart disease and who developed cardiac and renal failure postoperatively. A 0.2 mu g/kg per minute dosage of olprinone chlorate was administered intravenously for 120 minutes white the patient was treated w ith CVVHDF. Samples from the arterial and venous blood catheters and those from the ultradiafiltrate for 12 hours were collected to calculate pharmaco kinetic parameters and clearance of hemodiafiltration. The calculated param eters were as follows: half-life of elimination phase: 4.96 hours; total cl earance 3.40 ml/min per kg. The clearance of CVVHDF was 0.33 ml/min per kg. The olprinone chlorate clearance of CVVHDF approximates only 10% of total clearance in this case. CVVHDF may not produce significant reduction in the serum olprinone chlorate level. It is recommended that the infusion dosage of olprinone chlorate should be reduced when given to patients with renal failure even if treated with CVVHDF.