2026-04-17T14:49:44Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/137802025-10-24T08:51:33Zcom_2072_378070com_2072_378040com_2072_378071col_2072_378092col_2072_378097

2025-10-24T08:51:33Z urn:hdl:11351/13780 Pharmacokinetics of Isavuconazole During Extracorporeal Membrane Oxygenation Support in Critically Ill Patients: A Case Series Sosa, Manuel Puertas Sanjuan, Adrian Bonilla, Camilo Faixó, Patricia Guevara Chaux, Jessica Alejandra Vilanova, Albert Martínez-Pla, María Conto, Aldair Nuvials, Xavier Doménech-Moral, Laura García García, Sonia Pau-Parra, Alba Gallart Vivé, Elisabet Castellote Bellés, Laura Lalueza-Broto, Pilar Ferrer, Ricard Gorgas, Maria Queralt Riera del Brio, Jordi Medicaments antifúngics - Farmacocinètica Medicaments - Monitoratge Teràpia respiratòria Malalts en estat crític CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Antifungal Agents Other subheadings::Other subheadings::Other subheadings::/pharmacokinetics ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Respiratory Therapy::Extracorporeal Membrane Oxygenation DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Critical Illness ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Monitoring, Physiologic::Drug Monitoring COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antifúngicos Otros calificadores::Otros calificadores::Otros calificadores::/farmacocinética TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::terapia respiratoria::oxigenación por membrana extracorpórea ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::atributos de la enfermedad::enfermedad crítica TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::monitorización fisiológica::monitorización de medicamentos Antifungal therapy; Critical care; Pharmacokinetics Teràpia antifúngica; Cures intensives; Farmacocinètica Terapia antifúngica; Cuidados intensivos; Farmacocinética Background/objectives: Extracorporeal membrane oxygenation (ECMO) is increasingly used in critically ill patients, but may significantly alter the pharmacokinetics (PK) of antifungals. Data on plasma concentrations of Isavuconazole (IsaPlasm) in ECMO patients are limited. Our objective is to evaluate Isavuconazole exposure and variability in critically ill COVID-19 patients receiving ECMO. Methods: We conducted a pharmacokinetic analysis of Isavuconazole in critically ill patients receiving Veno-Venous ECMO for respiratory support. Plasma concentrations were measured using therapeutic drug monitoring (TDM) at multiple time points, including sampling before and after the membrane oxygenator. PK parameters-Area Under Curve (AUC0-24), Minimum Plasma Concentration (Cmin), Elimination Half-Life (T1/2), volume of distribution (Vd), and clearance (CL)-were estimated and compared with published data in non-ECMO populations. Results: Five patients were included. The median AUC0-24 was 227.3 µg·h/mL (IQR 182.4-311.35), higher than reported in non-ECMO patients. The median Vd was 761 L (727-832), suggesting extensive peripheral distribution and potential drug sequestration in the ECMO circuit. CL was increased (1.6 L/h, IQR 1.5-3.4). Two patients with recently replaced ECMO circuits exhibited significant drug loss across the membrane. Obesity and hypoalbuminemia were identified as factors associated with altered drug exposure. Conclusions: Isavuconazole pharmacokinetics show marked variability in critically ill ECMO patients. Increased AUC and Vd, along with reduced clearance, highlight the need for individualized dosing. 2025-10-24T08:51:33Z 2025-10-24T08:51:33Z 2025-10-06T08:01:13Z 2025-10-06T08:01:13Z 2025-06 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/13780 Antibiotics;14(6) https://doi.org/10.3390/antibiotics14060600 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess MDPI Scientia