Pharmacokinetics/Pharmacodynamics (PK/PD) of Fluconazole in Children on Extracorporeal Membrane Oxygenation (ECMO)
Status:
Completed
Trial end date:
2013-02-20
Target enrollment:
Participant gender:
Summary
Extracorporeal membrane oxygenation (ECMO) is a form of heart-lung bypass used to support
children who suffer heart or lung failure until whatever illness caused that failure can be
treated and reversed. While on ECMO, children are at increased risk of infection, including
fungal infection. Treatment for fungal infection includes not only antifungal medications but
also removal of any large intravenous (IV) lines. Since ECMO requires large IV lines, proper
treatment of fungal infections would be difficult if not impossible. The investigators
believe that giving prophylactic antifungal medication to all children on ECMO may prevent
fungal infections from developing in the first place.
Fluconazole is an antifungal medication that works well against the most common fungal
infections and has been shown to be safe in children. Unfortunately, the ECMO machine has the
potential to significantly alter the drug levels of medications so the investigators do not
know the proper dose of Fluconazole to give children on ECMO. Standard dosing of fluconazole
is 12mg per kilogram of body weight given intravenously once daily. Based on preliminary data
and modeling from other studies, the investigators think 25mg per kilogram given once weekly
will achieve proper drug levels to prevent fungal infections. The investigators have obtained
FDA approval to give this dose of fluconazole to children on ECMO who are enrolled in the
study. Blood samples will be collected at specific times around the first and second
fluconazole doses to describe the PK and drug extraction by the ECMO circuit.