Incidence of Infection and Antimicrobial Consumption in Ventricular Assist Device (VAD) Recipients at the Prince Charles Hospital (TPCH): A Retrospective Analysis.

Background: Ventricular assist devices (VADs) are frequently used as a bridge to heart transplant; however, infections are a common cause of increased morbidity and mortality. The optimal prophylactic antimicrobial regimen has not been effectively evaluated in literature.

Methods: Forty-three (43) patients received a VAD over the 5-year study period (2012-2017) at The Prince Charles Hospital (TPCH), Brisbane Australia.

Sedatives, analgesics and antipsychotics in tracheostomised ICU patients - Is less more?

Background: Sedation and anaesthesia are used universally to facilitate mechanical ventilation - with larger cumulative doses being used in those with prolonged ventilation. Transitioning from an endotracheal to a tracheostomy tube enables the depth of sedation to be reduced. Early use of speaking valves with tracheostomised patients has become routine in some intensive care units (ICU).

Incremental research approach to describing the pharmacokinetics of ciprofloxacin during extracorporeal membrane oxygenation.

Background: Significant interactions between drugs, extracorporeal membrane oxygenation (ECMO) circuits and critical illness may affect the pharmacokinetic properties of antibiotics in critically ill patients receiving ECMO.

Objective: To describe the pharmacokinetic properties of ciprofloxacin during ECMO by integrating pre-clinical findings (ie, ex vivo and in vivo ovine models) to a critically ill patient.

Design, Participants And Intervention: An ex vivo model of an ECMO circuit was used to describe ciprofloxacin concentration changes over 24 hours.

Sequestration of drugs in the circuit may lead to therapeutic failure during extracorporeal membrane oxygenation.

Introduction: Extracorporeal membrane oxygenation (ECMO) is a supportive therapy, with its success dependent on effective drug therapy that reverses the pathology and/or normalizes physiology. However, the circuit that sustains life can also sequester life-saving drugs, thereby compromising the role of ECMO as a temporary support device. This ex vivo study was designed to determine the degree of sequestration of commonly used antibiotics, sedatives and analgesics in ECMO circuits.

Development of simulated and ovine models of extracorporeal life support to improve understanding of circuit-host interactions.

Background: Extracorporeal life support (ECLS) is a lifesaving technology that is being increasingly used in patients with severe cardiorespiratory failure. However, ECLS is not without risks. The biosynthetic interface between the patient and the circuit can significantly alter inflammation, coagulation, pharmacokinetics and disposition of trace elements.