A narrative review on antimicrobial dosing in adult critically ill patients on extracorporeal membrane oxygenation
Myeongji Kim, Maryam Mahmood, Lynn L. Estes, John Wilson, Nathaniel Martin, Joseph E Marcus, Ankit Mittal, Casey O’Connell, Aditya Shah
Abstract
The optimal dosing strategy of antimicrobial agents in critically ill patients receiving extracorporeal membrane oxygenation (ECMO) is unknown. We conducted comprehensive review of existing literature on effect of ECMO on pharmacokinetics and pharmacodynamics of antimicrobials, including antibacterials, antifungals, and antivirals that are commonly used in critically ill patients. We aim to provide practical guidance to clinicians on empiric dosing strategy for these patients. Finally, we discuss importance of therapeutic drug monitoring, limitations of current literature, and future research directions.
Topics & Concepts
MedicineExtracorporeal membrane oxygenationCritically illIntensive care medicineDosingNarrative reviewCritical illnessAntimicrobialAnesthesiaPharmacologyMicrobiologyBiologyAntibiotics Pharmacokinetics and EfficacyMechanical Circulatory Support DevicesPoisoning and overdose treatments