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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Kriegl, L; Hatzl, S; Schilcher, G; Zollner-Schwetz, I; Boyer, J; Geiger, C; Hoenigl, M; Krause, R.
Antifungals in Patients With Extracorporeal Membrane Oxygenation: Clinical Implications.
Open Forum Infect Dis. 2024; 11(6): ofae270
Doi: 10.1093/ofid/ofae270
[OPEN ACCESS]
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- Leading authors Med Uni Graz
- Krause Robert
- Kriegl Lisa
- Co-authors Med Uni Graz
- Boyer Johannes
- Hatzl Stefan
- Hönigl Martin
- Schilcher Gernot
- Zollner-Schwetz Ines
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- Abstract:
- Extracorporeal membrane oxygenation (ECMO) is a life-saving technique used in critical care medicine for patients with severe respiratory or cardiac failure. This review examines the treatment and prophylaxis of fungal infections in ECMO patients, proposing specific regimens based on available data for different antifungals (azoles, echinocandins, amphotericin B/liposomal amphotericin B) and invasive fungal infections. Currently, isavuconazole and posaconazole have the most supported data, while modified dosages of isavuconazole are recommended in ECMO. Echinocandins are preferred for invasive candidiasis. However, choosing echinocandins is challenging due to limited and varied data on concentration loss in the ECMO circuit. Caution is likewise advised when using liposomal amphotericin B due to uncertain concentrations and potential ECMO dysfunction based on scarce data. We further conclude with the importance of further research on the impact of ECMO on antifungal drug concentrations to optimize dosing regimens in critically ill patients.
- Find related publications in this database (Keywords)
- antifungal prophylaxis
- antifungal treatment
- extracorporeal membrane oxygenation (ECMO)
- fungal infections
- intensive care