With his PhD student, they are trying to optimize medication and antibiotic therapy for children in pediatric intensive care units, with a special focus on continuous hemodialysis. In November, Dr. Csaba Lódi was named Supervisor of the Month.
Dr. Csaba Lódi is the head of the Intensive Care Unit at the Bókay Street Department, Pediatric Centre, Semmelweis University. He is a pediatric intensivist, neonatologist and pediatrician, who helps a PhD student, Dr. Kinga Budai. “She is a pharmacist who started her training at the Centre for Translational Medicine two years ago, and I am her supervisor. Her topic was inspired by the fact that children in intensive care units are given a wide range of medicine, and there is much less research on their application compared to adults. So there is much less data available on them. However, it is important to know about drug interactions, to know how different drugs affect each other. This helps avoiding unwanted effects.”
A program was started years ago in the intensive care unit of the pediatric clinic, and Dr. Budai joined in. “We are constantly monitoring the medical charts of the patients, and she pointed out what we should pay attention to, regarding medications. This helps us a lot in our daily work. We also managed to get the university lab to measure the levels of different antibiotics in blood. This gives the basis for Dr Budai's PhD thesis. Because of the clinical work, I am in daily contact with her, and since she is involved in translational medicine, we have special meetings at least once a week. As a result of this work, a meta-analysis on drug application was completed. We get a lot of help from the Centre for Translational Medicine, both from PhD students participating in training and from other colleagues. Our own research is related to the meta-analysis because we also examine drug efficacy.”
Dr. Budai and Dr. Lódi have an another topic, which is also important. This relates to the fact that the pediatrics clinic is also a kidney centre. “We perform continuous hemodialysis on children with serious conditions. That’s different from traditional dialysis, which takes 2-3 hours. Our patients receive dialysis 24 hours a day, which complicates drug administration because the dialyzer continuously filters drugs and metabolites from the blood. Therefore, it is a serious question of how effectively the active ingredients of the administered drugs can be utilized. Some ingredients can have their levels monitored, but many cannot.” There is very little data available on this topic, and few studies have been conducted so far. It also matters that dialysis is given to children in a variety of settings, there is no uniformized treatment. Everything is individual, and doctors perform everything according to individual needs, also considering the weight of the children. It is a very complex system, so they try to optimize the therapeutic range by comparing the antibiotic levels in the blood of children on dialysis with those who are not receiving dialysis. This ensures that the level is neither below nor above the required values. In such a case, there could be organ-damaging effects, which must be avoided at all costs.
(Emese Szabó)