American journal of veterinary research · 2026
Intermittent hemodialysis yields the highest baclofen elimination among 5 extracorporeal devices in equine whole blood ex vivo.
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Vigh Zsofia, Macfarlane Carley-Martin, Yeatts James L, Baynes Ronald, Land Lexi S, Ueda Yu, Her Jiwoong
Аннотация
OBJECTIVE: To compare baclofen removal by 5 devices across 3 modalities-intermittent hemodialysis (IHD) with low- and high-efficiency dialyzers, prolonged intermittent renal replacement therapy (PIRRT), and 2 hemoperfusion (HP) devices-in ex vivo equine blood. We hypothesized that IHD would be the most effective in baclofen elimination.
METHODS: Heparinized equine whole blood was spiked with reference baclofen and treated with low-efficiency IHD, high-efficiency IHD, PIRRT, carbon HP, polymer HP, and control. Each modality ran for 2 hours, targeting 20 times the assigned blood volume. Plasma baclofen was measured by UPLC-MS-MS at baseline and every 20 minutes. Elimination rate constants (k), reduction ratios, and extraction ratios were calculated from duplicate runs from April 29 through May 2, 2026.
RESULTS: Baclofen was eliminated the fastest by IHD (k, almost equal to 2.7 h-1 for both dialyzers; half-life, almost equal to 15 minutes), then PIRRT (k, 2.3 h-1), and most slowly by HP (1.7 and 1.3 h-1 for carbon HP and polymer HP). Between-run variability was lowest for PIRRT (coefficient of variation, 6%) and highest for carbon HP (coefficient of variation, 77%). Reduction ratios were 99.4% (both IHD), 98.9% (PIRRT), 92.7% (polymer HP), and 89.2% (carbon HP).
CONCLUSIONS: All modalities substantially reduced baclofen in equine blood ex vivo. Based on the elimination rate constant, IHD was the most effective modality for baclofen elimination.
CLINICAL RELEVANCE: Intermittent hemodialysis achieves the most rapid removal. In vivo studies are warranted to compare the performance and efficacy of each modality across clinical settings.
METHODS: Heparinized equine whole blood was spiked with reference baclofen and treated with low-efficiency IHD, high-efficiency IHD, PIRRT, carbon HP, polymer HP, and control. Each modality ran for 2 hours, targeting 20 times the assigned blood volume. Plasma baclofen was measured by UPLC-MS-MS at baseline and every 20 minutes. Elimination rate constants (k), reduction ratios, and extraction ratios were calculated from duplicate runs from April 29 through May 2, 2026.
RESULTS: Baclofen was eliminated the fastest by IHD (k, almost equal to 2.7 h-1 for both dialyzers; half-life, almost equal to 15 minutes), then PIRRT (k, 2.3 h-1), and most slowly by HP (1.7 and 1.3 h-1 for carbon HP and polymer HP). Between-run variability was lowest for PIRRT (coefficient of variation, 6%) and highest for carbon HP (coefficient of variation, 77%). Reduction ratios were 99.4% (both IHD), 98.9% (PIRRT), 92.7% (polymer HP), and 89.2% (carbon HP).
CONCLUSIONS: All modalities substantially reduced baclofen in equine blood ex vivo. Based on the elimination rate constant, IHD was the most effective modality for baclofen elimination.
CLINICAL RELEVANCE: Intermittent hemodialysis achieves the most rapid removal. In vivo studies are warranted to compare the performance and efficacy of each modality across clinical settings.