Impact of extracorporeal membrane oxygenation on antituberculosis drug concentrations: A case study and pharmaceutical care strategies.

BACKGROUND

Extracorporeal membrane oxygenation (ECMO) provides life support for critically ill tuberculosis (TB) patients. However, during ECMO therapy, significant fluctuations in the plasma concentration of anti-TB drugs occur due to drug adsorption in the ECMO circuit, hemodilution, and metabolic disturbances.

MATERIALS AND

METHODS

This single-case study monitored the plasma concentration of anti-TB drugs in a TB patient supported by ECMO.

RESULTS

The differences in peak plasma concentrations (Cmax) measured at the end of ECMO support vs. 7 days after ECMO withdrawal were as follows: isoniazid (66%), linezolid (63%), ethambutol (56%), and levofloxacin (12%).

CONCLUSION

We analyzed ECMO's impact on drug concentrations and implemented therapeutic drug monitoring to optimize therapy. However, this single-case study has inherent limitations; future multi-center studies are warranted to validate these findings.