Cefamandole kinetics during cardiopulmonary bypass

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Abstract
The kinetics of cefamandole during cardiac surgery was studied in 16 adult patients given a single intravenous infusion of 20 mg/kg at the time of anesthesia induction. Five normal volunteers who received the same dose served as controls. Cardiopulmonary bypass (CPB) was found to significantly increase the half-life (t½) of cefamandole. The mean t½ during CP B (113.2 min) was longer than the terminal t½ in normal volunteers (52.0 min; p < 0.005). Throughout CPB (maximum, 3.7 hr), cefamandole plasma levels were maintained above the minimum inhibitory concentration for those organisms most likely to cause postoperative infections. We conclude that if 20 mg/kg of cefamandole is given within an hour of the beginning of cardiovascular surgery, a supplemental dose is not needed until the patient has been on CPB for at least four hours.