keyword
MENU ▼
Read by QxMD icon Read
search

Ecmo, drug dosing

keyword
https://www.readbyqxmd.com/read/29042837/vancomycin-dosing-in-pediatric-extracorporeal-membrane-oxygenation-potential-impacts-of-new-technologies
#1
Kevin P Lonabaugh, Kelly J Lunsford, Gary Y Fang, David A Kaufman, Samuel D Addison, Marcia L Buck
OBJECTIVES: The objective of the current study was to evaluate the doses of vancomycin used to obtain therapeutic drug concentrations in pediatric patients on extracorporeal membrane oxygenation (ECMO), using new ECMO technologies. METHODS: This was a single-center, retrospective study of patients treated with vancomycin while receiving ECMO using low-volume circuit technology. RESULTS: A total of 28 patients were included in the analysis of the primary endpoint...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29042836/evaluation-of-the-effects-of-extracorporeal-membrane-oxygenation-on-antiepileptic-drug-serum-concentrations-in-pediatric-patients
#2
Nicholas O Dillman, Mindl M Messinger, Kimberly N Dinh, Jennifer L Placencia, Brady S Moffett, Milenka Cuevas Guaman, Jennifer C Erklauer, Jeffrey R Kaiser, Angus A Wilfong
OBJECTIVES: Patients supported on extracorporeal membrane oxygenation (ECMO) have an increased incidence of seizures. Phenobarbital (PB) and fosphenytoin (fos-PHT) are common antiepileptic drugs (AEDs) used to manage seizures in the pediatric population; however, it is unknown what effect ECMO has on the serum concentrations of AEDs. The purpose of this study is to evaluate the effect of ECMO on AED serum concentrations. METHODS: A retrospective, matched-cohort study was performed in patients younger than 18 years who received ECMO and were treated with intravenous (IV) PB or fos-PHT at Texas Children's Hospital between 2004 and 2014...
September 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28979038/antifungal-extraction-by-the-extracorporeal-membrane-oxygenation-circuit
#3
Kevin M Watt, Michael Cohen-Wolkowiez, Duane C Williams, Desiree K Bonadonna, Ira M Cheifetz, Dhiren Thakker, Daniel K Benjamin, Kim L R Brouwer
Invasive candidiasis is common and often fatal in patients supported with extracorporeal membrane oxygenation (ECMO), and treatment relies on optimal antifungal dosing. The ECMO circuit can extract drug and decrease drug exposure, placing the patient at risk of therapeutic failure. This ex vivo study determined the extraction of antifungal drugs by the ECMO circuit. Fluconazole and micafungin were studied separately in three closed-loop circuit configurations to isolate the impact of the oxygenator, hemofilter, and tubing on circuit extraction...
September 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28948652/pharmacokinetic-changes-of-antibiotic-antiviral-antituberculosis-and-antifungal-agents-during-extracorporeal-membrane-oxygenation-in-critically-ill-adult-patients
#4
REVIEW
J Hahn, J H Choi, M J Chang
WHAT IS KNOWN AND OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) is a life-saving system used for critically ill patients with cardiac and/or respiratory failure. The pharmacokinetics (PK) of drugs can change in patients undergoing ECMO, which can result in therapeutic failure or drug toxicity requiring further management of drug complications. In this review, we discussed changes in the PK of antibiotic, antiviral, antituberculosis and antifungal agents administered to adult patients on ECMO...
September 25, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28887935/medication-complications-in-extracorporeal-membrane-oxygenation
#5
REVIEW
Ami G Shah, Michelle Peahota, Brandi N Thoma, Walter K Kraft
The need for extracorporeal membrane oxygenation (ECMO) therapy is a marker of disease severity for which multiple medications are required. The therapy causes physiologic changes that impact drug pharmacokinetics. These changes can lead to exposure-driven decreases in efficacy or increased incidence of side effects. The pharmacokinetic changes are drug specific and largely undefined for most drugs. We review available drug dosing data and provide guidance for use in the ECMO patient population.
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28674057/population-pharmacokinetics-and-dose-optimization-of-teicoplanin-during-venoarterial-extracorporeal-membrane-oxygenation
#6
Jin Wi, Hayeon Noh, Kyoung Lok Min, Seungwon Yang, Byung Hak Jin, Jongsung Hahn, Soo Kyung Bae, Jiseon Kim, Min Soo Park, Donghoon Choi, Min Jung Chang
The pharmacokinetics (PK) of drugs are known to be significantly altered in patients receiving extracorporeal membrane oxygenation (ECMO). However, clinical studies of the PK of drugs administered during ECMO are scarce, and the proper dosing adjustment has yet to be established. We developed a population PK model for teicoplanin, investigated covariates influencing teicoplanin exposure, and suggested an optimal dosing regimen for ECMO patients. Samples for PK analysis were collected from 10 adult patients, and a population PK analysis and simulations were performed to identify an optimal teicoplanin dose needed to provide a >50% probability of target attainment at 72 h using a trough concentration target of >10 μg/ml for mild to moderate infections and a trough concentration target of >15 μg/ml for severe infections...
September 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28638161/argatroban-for-heparin-induced-thrombocytopenia-during-venovenous-extracorporeal-membrane-oxygenation-with-continuous-venovenous-hemofiltration
#7
Jonathan H Sin, Natasha D Lopez
Patients receiving extracorporeal membrane oxygenation (ECMO) are at risk of circuit thrombosis due to constant contact between blood and the extracorporeal components. Unfractionated heparin has traditionally been used in this setting as a systemic form of anticoagulation to prevent thrombosis of the circuit. However, if a patient develops heparin-induced thrombocytopenia (HIT), an alternative anticoagulant would be required while the patient is maintained on ECMO. Unfortunately, the pharmacokinetic changes induced by ECMO and critical illness may potentially affect optimal drug dosing...
June 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28387487/-how-i-treat-%C3%A2-severe-beta-blocker-poisoning-pharmacological-approaches-and-ecmo
#8
P Horward, B Lambermont, J-O Defraigne, C Gurdebeke, P Morimont
We report the case of a woman with severe beta-blocker poisoning who, after failure of pharmacological therapy, was supported with an ECMO (ExtraCorporeal Membrane Oxygenation) device. We discuss conventional pharmacological treatments and other approaches that have emerged over the past decade such as high dose insulin therapy and lipid emulsions. Major advance has been achieved in the field of ECMO devices and their management. ECMO is now the first line device for refractory acute cardiac and/or pulmonary failure...
March 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28384599/the-effect-of-veno-venous-ecmo-on-the-pharmacokinetics-of-ritonavir-darunavir-tenofovir-and-lamivudine
#9
Mohamed A Ghazi Suliman, Kayode Ogungbenro, Christos Kosmidis, Alan Ashworth, Julian Barker, Anita Szabo-Barnes, Andrew Davies, Lee Feddy, Igor Fedor, Tim Hayes, Sarah Stirling, Ignacio Malagon
INTRODUCTION: To our knowledge, there is no published data on the pharmacokinetic (PK) profile of antiretroviral (ART) drugs on patients undergoing extracorporeal membrane oxygenation (ECMO) therapy. We present PK analyses of Ritonavir, Darunavir, Lamivudine and Tenofovir in a patient with HIV who required veno-venous ECMO (VV ECMO). METHODS: Plasma concentrations for Ritonavir, Darunavir, Tenofovir and Lamivudine were obtained while the patient was on ECMO following pre-emptive dose adjustments...
March 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28078682/population-pharmacokinetics-of-intravenous-clonidine-for-sedation-during-paediatric-extracorporeal-membrane-oxygenation-and-continuous-venovenous-hemofiltration
#10
Niina Kleiber, Ron A A Mathôt, Maurice J Ahsman, Enno D Wildschut, Dick Tibboel, Saskia N de Wildt
AIMS: Clonidine is used for sedation in the paediatric intensive care unit. Extracorporeal membrane oxygenation (ECMO) provides temporary support if respiratory and cardiac function is threatened. ECMO influences the pharmacokinetics of drugs. Clonidine during paediatric ECMO cannot be effectively titrated as PK data are lacking. The aim of this study is to describe clonidine PK in a particular ECMO system and propose dosing guidelines for children on this particular ECMO circuit. METHODS: All children below the age of 18 years who received clonidine during ECMO were eligible...
June 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27931091/evaluation-of-altered-drug-pharmacokinetics-in-critically-ill-adults-receiving-extracorporeal-membrane-oxygenation
#11
REVIEW
Michael A Ha, Adam C Sieg
Extracorporeal membrane oxygenation (ECMO) is a life-support modality used in patients with refractory cardiac and/or respiratory failure. A significant resurgence in the use ECMO has been seen in recent years as a result of substantial improvements in technology and survival benefit. With expanding ECMO use, a better understanding of how ECMO affects drug pharmacokinetics (PK) is necessary. The vast majority of PK studies in patients receiving ECMO have been conducted within neonatal or pediatric populations or within a controlled environment (e...
February 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/27815558/in-vitro-effects-of-an-extracorporeal-membrane-oxygenation-circuit-on-the-sequestration-of-%C3%AF%C2%B5-aminocaproic-acid
#12
Deborah Wagner, Miguel Caraballo, John Waldvogel, Yuki Peterson, Duxin Sun
OBJECTIVE: To assess the in vitro effects of drug sequestration in extracorporeal membrane oxygenation (ECMO) on ϵ-aminocaproic acid (EACA) concentrations. METHODS AND DESIGN: This in vitro study will determine changes in EACA concentration over time in ECMO circuits. A pediatric dose of 2,500 mg was administered to whole expired blood in the simulated pediatric ECMO circuit. Blood samples were collected at 0, 30, 60, 360 and 1440-minute intervals after initial administration equilibration from three different sites of the circuit: pre-oxygenator (PRE), post-oxygenator (POST) and PVC tubing (PVC) to determine the predominant site of drug loss...
April 2017: Perfusion
https://www.readbyqxmd.com/read/27667276/-the-effect-and-factors-associated-with-outcome-of-extracorporeal-membrane-oxygenation-in-refractory-cardiogenic-shock-patients
#13
R Q Zhu, C Z Liu, J H Lu, Y P Su, S C Wen, G J Nie, Y Z Hu, L E Zuo
Objective: To observe the clinical efficacy and factors associated with outcome of extracorporeal membrane oxygenation (ECMO) in refractory cardiogenic shock patients. Methods: Patients with refractory cardiogenic shock received ECMO treatment in our hospital from May 2013 to November 2015 were retrospectively analyzed. The clinical status before ECMO support, ECMO timing, complications and outcome were observed and analyzed.The hemodynamic data and the amount of vasoactive drugs at 2 hours before ECMO support and at 2, 6, 24 and 48 hours after ECMO support were collected and compared...
September 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27553752/pharmacokinetics-and-dosing-of-anti-infective-drugs-in-patients-on-extracorporeal-membrane-oxygenation-a-review-of-the-current-literature
#14
REVIEW
Jennifer Sherwin, Travis Heath, Kevin Watt
PURPOSE: Extracorporeal membrane oxygenation (ECMO) is a cardiopulmonary bypass device that is used to temporarily support the most critically ill of patients with respiratory and/or cardiac failure. Infection and its sequelae may be an indication for ECMO or infections may be acquired while on ECMO and are associated with a mortality >50%. Effective therapy requires optimal dosing. However, optimal dosing can be different in patients on ECMO because the ECMO circuit can alter drug pharmacokinetics...
September 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27322360/pharmacotherapy-during-pediatric-extracorporeal-membrane-oxygenation-a-review
#15
REVIEW
Adam S Himebauch, Todd J Kilbaugh, Athena F Zuppa
INTRODUCTION: Pediatric critical illness and associated alterations in organ function can change drug pharmacokinetics (PK). Extracorporeal membrane oxygenation (ECMO), a life-saving therapy for severe cardiac and/or respiratory failure, causes additional PK alterations that affect drug disposition. AREAS COVERED: The purposes of this review are to discuss the PK changes that occur during ECMO, the associated therapeutic implications, and to review PK literature relevant to pediatric ECMO...
October 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27314826/pharmacokinetics-and-safety-of-micafungin-in-infants-supported-with-extracorporeal-membrane-oxygenation
#16
Julie Autmizguine, Christoph P Hornik, Daniel K Benjamin, Kim L R Brouwer, Susan R Hupp, Michael Cohen-Wolkowiez, Kevin M Watt
BACKGROUND: Candida is a leading cause of infection in infants on extracorporeal membrane oxygenation (ECMO). Optimal micafungin dosing is unknown in this population because ECMO can alter drug pharmacokinetics (PK). METHODS: To characterize micafungin pharmacokinetics and safety in infants on ECMO, we conducted an open-label pharmacokinetics trial. Infants on ECMO either received intravenous micafungin 4 mg/kg every 24 h for invasive candidiasis prophylaxis or 8 mg/kg every 24 h when a fungal infection was suspected or confirmed...
November 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/26913719/survival-after-cardiac-arrest-ecmo-rescue-therapy-after-amlodipine-and-metoprolol-overdose
#17
Kevin F Maskell, Nikki Miller Ferguson, Jesse Bain, Brandon K Wills
Extracorporeal membrane oxygenation (ECMO) use in poisoned patients is increasing, but is rare post cardiac arrest. We report a case of ECMO use with complete recovery in a patient who arrested twice after a cardiotoxicant overdose. A 17-year-old male presented after an unknown overdose. He rapidly became hypotensive and bradycardic and received aggressive supportive care without improvement. He was transferred to our institution and suffered a cardiac arrest shortly after arrival. Six minutes of advanced cardiac life support resulted in return of spontaneous circulation...
April 2017: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/26667471/can-physicochemical-properties-of-antimicrobials-be-used-to-predict-their-pharmacokinetics-during-extracorporeal-membrane-oxygenation-illustrative-data-from-ovine-models
#18
Kiran Shekar, Jason A Roberts, Adrian G Barnett, Sara Diab, Steven C Wallis, Yoke L Fung, John F Fraser
INTRODUCTION: Ex vivo experiments in extracorporeal membrane oxygenation (ECMO) circuits have identified octanol-water partition coefficient (logP, a marker of lipophilicity) and protein binding (PB) as key drug factors affecting pharmacokinetics (PK) during ECMO. Using ovine models, in this study we investigated whether these drug properties can be used to predict PK alterations of antimicrobial drugs during ECMO. METHODS: Single-dose PK sampling was performed in healthy sheep (HS, n = 7), healthy sheep on ECMO (E24H, n = 7) and sheep with smoke inhalation acute lung injury on ECMO (SE24H, n = 6)...
December 15, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26518065/single-and-multiple-dose-pharmacokinetics-of-ethambutol-and-rifampicin-in-a-tuberculosis-patient-with-acute-respiratory-distress-syndrome-undergoing-extended-daily-dialysis-and-ecmo-treatment
#19
Ann-Kathrin Strunk, Sandra Ciesek, Julius J Schmidt, Christian Kühn, Marius M Hoeper, Tobias Welte, Jan T Kielstein
The dosing of drugs in critically ill patients undergoing renal replacement therapy is based on limited data. We report for the first time single- and multiple-dose pharmacokinetics of ethambutol (EMB), which is cleared renally to 80%, and rifampicin (RIF), which is cleared renally to <30%, in a patient requiring both extracorporeal membrane oxygenation (ECMO) and renal replacement therapy. Extended dialysis removed a considerable amount of both EMB and RIF, with a dialyser plasma clearance ranging between 37 and 95 ml/min for EMB and between 39 and 53 ml/min for RIF...
January 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/26512570/a-case-report-of-churg-strauss-syndrome-presenting-with-cardiogenic-shock-treated-with-extracorporeal-membrane-oxygenation
#20
Na Cui, Longxiang Su, Hao Wang, Yun Long, Cheng Pang, Fei Yang, Dawei Liu
Churg-Strauss Syndrome (CSS) complicated with cardiogenic shock is rare. Few case reports have described successful treatment of this rare disease. However, no one has reported on the application of mechanical life support with extracorporeal membrane oxygenation (ECMO) to treat this life-threatening disease.A 36-year-old female with limb numbness for >10 days, chest tightness for 2 days, and worsening dyspnea for 5 h presented in the emergency room. Vital signs showed a low blood pressure (104/60 mm Hg), increased heart rate (158 bpm), and respiration rate (28 bpm)...
October 2015: Medicine (Baltimore)
keyword
keyword
107808
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"