Extracorporeal membrane oxygenation for blastomycosis-related severe ARDS: a new indication as a rescue therapy?

Steinberg, Benjamin E.; Goldenberg, Neil M.; Laffey, John G.

doi:10.1007/s12630-015-0377-0

Cited by 3 publications

(1 citation statement)

References 5 publications

(9 reference statements)

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“… 31 Whereas these small numbers fall short of statistical significance, they do suggest that a role for ECMO in ARDS caused by blastomycosis should be explored further. 34 …”

Section: Discussionmentioning

confidence: 99%

Management and Outcomes of Acute Respiratory Distress Syndrome Caused by Blastomycosis

et al. 2016

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“… 31 Whereas these small numbers fall short of statistical significance, they do suggest that a role for ECMO in ARDS caused by blastomycosis should be explored further. 34 …”

Section: Discussionmentioning

confidence: 99%

Management and Outcomes of Acute Respiratory Distress Syndrome Caused by Blastomycosis

et al. 2016

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Altered Pharmacokinetics and Dosing of Liposomal Amphotericin B and Isavuconazole during Extracorporeal Membrane Oxygenation

et al. 2019

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Drug pharmacokinetics may be significantly altered in patients receiving extracorporeal membrane oxygenation (ECMO). Ensuring the optimized effective dosing of antimicrobials on ECMO remains a challenge. To date, limited data are available regarding the optimal use of amphotericin and triazoles during ECMO. We report a case of altered pharmacokinetics, insufficient liposomal amphotericin B and isavuconazole levels, and the need for escalated doses during ECMO in a patient with severe acute respiratory distress syndrome secondary to pulmonary blastomycosis. A 2‐fold increase in the standard total daily dose of both drugs was necessary to overcome low serum concentrations thought to be secondary to drug loss from ECMO circuit sequestration. These findings have important implications for optimizing antimicrobial therapy in patients receiving ECMO to maximize therapeutic efficacy. The use of therapeutic drug monitoring for patients receiving antimicrobial therapy with concurrent ECMO may facilitate appropriate drug dosing to achieve adequate serum concentrations and optimize favorable patient outcomes. Further studies exploring antimicrobial pharmacokinetics during ECMO are needed to inform dosing recommendations in critically ill patients.

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Successful Treatment of Refractory Hypoxemia Secondary to Disseminated Histoplasmosis Using Extracorporeal Membrane Oxygenation Support

Wanta

Tyner²,

Baddour³

2016

A & A Case Reports

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Refractory hypoxemia secondary to acute respiratory distress syndrome (ARDS) is associated with high mortality. Extracorporeal membraneoxygenation (ECMO) is an accepted strategy for treating refractory hypoxemia in patients with ARDS but is relatively contraindicated in the setting of systemic infections. We present a case of successful ECMO use in a host with refractory hypoxemia secondary to disseminated histoplasmosis with fungemia and discuss our management approach to this difficult patient.

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Extracorporeal membrane oxygenation for blastomycosis-related severe ARDS: a new indication as a rescue therapy?

Cited by 3 publications

References 5 publications

Management and Outcomes of Acute Respiratory Distress Syndrome Caused by Blastomycosis

Management and Outcomes of Acute Respiratory Distress Syndrome Caused by Blastomycosis

Altered Pharmacokinetics and Dosing of Liposomal Amphotericin B and Isavuconazole during Extracorporeal Membrane Oxygenation

Successful Treatment of Refractory Hypoxemia Secondary to Disseminated Histoplasmosis Using Extracorporeal Membrane Oxygenation Support

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