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.

Background and purpose: Right ventricular dysfunction (RVD) has been described as an independent factor for morbidity and/ or mortality in various nosological entities. However, there are no data on its true prevalence in hospital environments. The present study aims to discover the prevalence of this pathology at a specialized hospital center, as well as the characteristics of the patients affected. Methods and results: An observational and prospective study analyzing 7636 echocardiographs performed consecutively over a 20-month period. An etiological classification into four categories (cardiac cause, pulmonary thromboembolism, pneumopathy and idiopathic pulmonary hypertension) was proposed. 442 RVD cases were detected and classified, which is 5.78% of the examinations performed. Most of the cases (87.56%) presented prior cardiopathy as the origin of RVD. Only 12.44% presented a non-cardiac cause for RVD. Differences were detected in the demographic and echocardiographic characteristics of patients, depending on the etiology of the RVD. Conclusions: With a prevalence of 5.78% of all the echocardiographs performed in a specialized hospital, the significance of RVD is confirmed. The most frequent etiological factor for this disease is the existence of prior heart disease.

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