Graduation Date

Summer 8-12-2022

Document Type

Thesis

Degree Name

Master of Science (MS)

Programs

Medical Sciences Interdepartmental Area

First Advisor

Daryl J Murray, PharmD

Second Advisor

Kim Scarsi, PharmD

Third Advisor

Keith Olsen, PharmD

Abstract

A series of studies within the setting of extracorporeal membrane oxygenation (ECMO) was undertaken to specifically answer questions related to medication optimization during this complex therapy. These studies included medication therapies involving optimal anticoagulation, analgesia delivery, fluid resuscitation, and infection related outcomes in the context of ECMO. Each investigation was retrospective in nature and included patients from a single institution. The results of these studies indicated the following: 1.) various anticoagulation goals do not impact severe, life-threatening bleeding events during ECMO therapy; 2.) sepsis is a common occurrence in the setting of ECMO; 3.) the choice of either a crystalloid or albumin dense resuscitation effort does not impact fluid balance within 48 hours of ECMO cannulation, and 4.) that the utilization of hydromorphone analgesia during ECMO results in less opioid exposure compared to fentanyl therapy. This research undertaken presents a foundation to continue further studies in this complex landscape. Future studies including prospective analysis would aid in the most objective understanding of optimal pharmaceutical care during ECMO utilization.

Available for download on Wednesday, August 02, 2023

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