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Observational Study
. 2020 Jun;32(2):277-283.
doi: 10.5935/0103-507x.20200044. Epub 2020 Jul 13.

Pharmacokinetics of micafungin in patients treated with extracorporeal membrane oxygenation: an observational prospective study

[Article in English, Portuguese]
Marta López-Sánchez  1 , Ignacio Moreno-Puigdollers  2 , Maria Isabel Rubio-López  1 , Iratxe Zarragoikoetxea-Jauregui  2 , Rosario Vicente-Guillén  2 , Maria Pilar Argente-Navarro  2
Affiliations
Observational Study

Pharmacokinetics of micafungin in patients treated with extracorporeal membrane oxygenation: an observational prospective study

[Article in English, Portuguese]
Marta López-Sánchez et al. Rev Bras Ter Intensiva. 2020 Jun.

Abstract
in English, Portuguese

Objective: To determine micafungin plasma levels and pharmacokinetic behavior in patients treated with extracorporeal membrane oxygenation.

Methods: The samples were taken through an access point before and after the membrane in two tertiary hospitals in Spain. The times for the calculation of pharmacokinetic curves were before the administration of the drug and 1, 3, 5, 8, 18 and 24 hours after the beginning of the infusion on days one and four. The area under the curve, drug clearance, volume of distribution and plasma half-life time with a noncompartmental pharmacokinetic data analysis were calculated.

Results: The pharmacokinetics of the values analyzed on the first and fourth day of treatment did not show any concentration difference between the samples taken before the membrane (Cin) and those taken after the membrane (Cout), and the pharmacokinetic behavior was similar with different organ failures. The area under the curve (AUC) before the membrane on day 1 was 62.1 (95%CI 52.8 - 73.4) and the AUC after the membrane on this day was 63.4 (95%CI 52.4 - 76.7), p = 0.625. The AUC before the membrane on day 4 was 102.4 (95%CI 84.7 - 142.8) and the AUC was 100.9 (95%CI 78.2 - 138.8), p = 0.843.

Conclusion: The pharmacokinetic parameters of micafungin were not significantly altered.

Objetivo: Determinar os níveis plasmáticos e o comportamento farmacocinético da micafungina em pacientes tratados com oxigenação por membrana extracorpórea.

Métodos: As amostras foram colhidas por meio de pontos de acesso antes e depois da membrana, em dois hospitais espanhóis de nível terciário. Os momentos para o cálculo das curvas farmacocinéticas foram antes da administração do fármaco, e 1, 3, 5, 8, 18 e 24 horas após o início da infusão nos dias 1 e 4 de tratamento. Calcularam-se a área sob a curva, a depuração do fármaco, o volume de distribuição e a meia-vida plasmática por meio de análise farmacocinética não compartimental.

Resultados: Os valores farmacocinéticos analisados no primeiro e quarto dias de tratamento não mostram qualquer diferença de concentração entre amostras colhidas antes da membrana e após a membrana, e o comportamento farmacocinético foi similar na vigência de diferentes falências de órgãos. A área sob a curva antes da membrana no dia 1 foi de 62,1 (IC95% 52,8 - 73,4) e a área sob a curva após a membrana nesse mesmo dia foi de 63,4 (IC95% 52,4 - 76,7), com p = 0,625. A área sob a curva antes da membrana no dia 4 foi de 102,4 (IC95% 84,7 - 142,8), enquanto a área sob a curva após a membrana nesse mesmo dia foi de 100,9 (IC95% 78,2 - 138,8), com p = 0,843.

Conclusão: Os parâmetros farmacocinéticos da micafungina não foram alterados significantemente.

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Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1
Micafungin concentrations determined in samples over 24 hours from the venous pre-extracorporeal membrane oxygenation port (Cin) and the venous postextracorporeal membrane oxygenation port (Cout) on day 1 (A) and day 4 (B).
See this image and copyright information in PMC

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