Reply to Béranger et al., "Integration of Continuous Renal Replacement Therapy in a Meropenem Population Pharmacokinetics Model in Critically Ill Children".

We welcome Beranger et al.'s response to our recent publication (1), and we agree that the effect of continuous renal replacement therapy (CRRT) on pharmacokinetic parameters for meropenem (MEM) should be discussed. As Beranger et al. pointed out, extracorporeal membrane oxygenation (ECMO) was probably a component of the CRRT covariate, and it may have contributed to the increase in central volume of distribution. In fact, the circuit priming volume for ECMO can be several times higher than the pediatric patient's blood volume, and hemodilution effect is inversely related to age (2).….