Oxandrolone in Patients on Venovenous Extracorporeal Membrane Oxygenation: A Case Series
Venovenous extracorporeal membrane oxygenation (VV ECMO) induces a systemic inflammatory response, which may progress to persistent inflammation, immunosuppression, and catabolism syndrome (PICS). The anabolic steroid oxandrolone may improve the metabolic aberrations of PICS. We report our experienc...
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| Veröffentlicht in: | Nutrition in clinical practice 2020-06, Vol.35 (3), p.514-521 |
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| creator | Pelekhaty, Stacy L. Pajoumand, Mehrnaz Omanwa, Kristen S. Galvagno Jr, Samuel M. Lantry, James H. Deatrick, Kristopher B. Cornachione, Christopher R. Menaker, Jay |
| description | Venovenous extracorporeal membrane oxygenation (VV ECMO) induces a systemic inflammatory response, which may progress to persistent inflammation, immunosuppression, and catabolism syndrome (PICS). The anabolic steroid oxandrolone may improve the metabolic aberrations of PICS. We report our experience with 3 patients on VV ECMO who received oxandrolone after demonstrating refractory catabolism on serial nitrogen balance (NB) studies or persistent weakness. Patients in cases 1 and 3 were started on oxandrolone on VV ECMO days 45 and 29, respectively, for negative NB despite nutrition optimization. The case 2 patient started oxandrolone for persistent weakness 68 days after cannulation. All patients demonstrated improvements in NB results. One patient developed mild transaminitis while on oxandrolone, which did not alter his medication course and resolved after the medication was discontinued. The impact of oxandrolone on functional capacity varied between patients. Oxandrolone may be beneficial in persistently catabolic VV ECMO patients to improve NB results. In some patients, this may support functional recovery. Additional research is needed to identify optimal patients for therapy and to investigate the impact of oxandrolone in this population. |
| doi_str_mv | 10.1002/ncp.10468 |
| format | Article |
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The anabolic steroid oxandrolone may improve the metabolic aberrations of PICS. We report our experience with 3 patients on VV ECMO who received oxandrolone after demonstrating refractory catabolism on serial nitrogen balance (NB) studies or persistent weakness. Patients in cases 1 and 3 were started on oxandrolone on VV ECMO days 45 and 29, respectively, for negative NB despite nutrition optimization. The case 2 patient started oxandrolone for persistent weakness 68 days after cannulation. All patients demonstrated improvements in NB results. One patient developed mild transaminitis while on oxandrolone, which did not alter his medication course and resolved after the medication was discontinued. The impact of oxandrolone on functional capacity varied between patients. Oxandrolone may be beneficial in persistently catabolic VV ECMO patients to improve NB results. In some patients, this may support functional recovery. Additional research is needed to identify optimal patients for therapy and to investigate the impact of oxandrolone in this population.</description><identifier>ISSN: 0884-5336</identifier><identifier>EISSN: 1941-2452</identifier><identifier>DOI: 10.1002/ncp.10468</identifier><identifier>PMID: 32083363</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; anabolic agents ; Anabolic Agents - therapeutic use ; critical illness ; extracorporeal membrane oxygenation ; Extracorporeal Membrane Oxygenation - adverse effects ; Extracorporeal Membrane Oxygenation - methods ; Female ; Humans ; Immune Tolerance - drug effects ; Inflammation - etiology ; Inflammation - prevention & control ; Male ; Metabolism - drug effects ; Muscle Proteins - metabolism ; nitrogen balance ; Nursing ; nutrition support ; Nutritional Support ; oxandrolone ; Oxandrolone - therapeutic use ; Respiratory Insufficiency - therapy ; Young Adult</subject><ispartof>Nutrition in clinical practice, 2020-06, Vol.35 (3), p.514-521</ispartof><rights>2020 American Society for Parenteral and Enteral Nutrition</rights><rights>2020 American Society for Parenteral and Enteral Nutrition.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3258-8f188e0e812304dcd09a5480c39560eb9081d0d2e29fc3515464de88bb2c8a803</citedby><cites>FETCH-LOGICAL-c3258-8f188e0e812304dcd09a5480c39560eb9081d0d2e29fc3515464de88bb2c8a803</cites><orcidid>0000-0002-8060-5389</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fncp.10468$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fncp.10468$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32083363$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pelekhaty, Stacy L.</creatorcontrib><creatorcontrib>Pajoumand, Mehrnaz</creatorcontrib><creatorcontrib>Omanwa, Kristen S.</creatorcontrib><creatorcontrib>Galvagno Jr, Samuel M.</creatorcontrib><creatorcontrib>Lantry, James H.</creatorcontrib><creatorcontrib>Deatrick, Kristopher B.</creatorcontrib><creatorcontrib>Cornachione, Christopher R.</creatorcontrib><creatorcontrib>Menaker, Jay</creatorcontrib><title>Oxandrolone in Patients on Venovenous Extracorporeal Membrane Oxygenation: A Case Series</title><title>Nutrition in clinical practice</title><addtitle>Nutr Clin Pract</addtitle><description>Venovenous extracorporeal membrane oxygenation (VV ECMO) induces a systemic inflammatory response, which may progress to persistent inflammation, immunosuppression, and catabolism syndrome (PICS). The anabolic steroid oxandrolone may improve the metabolic aberrations of PICS. We report our experience with 3 patients on VV ECMO who received oxandrolone after demonstrating refractory catabolism on serial nitrogen balance (NB) studies or persistent weakness. Patients in cases 1 and 3 were started on oxandrolone on VV ECMO days 45 and 29, respectively, for negative NB despite nutrition optimization. The case 2 patient started oxandrolone for persistent weakness 68 days after cannulation. All patients demonstrated improvements in NB results. One patient developed mild transaminitis while on oxandrolone, which did not alter his medication course and resolved after the medication was discontinued. The impact of oxandrolone on functional capacity varied between patients. Oxandrolone may be beneficial in persistently catabolic VV ECMO patients to improve NB results. In some patients, this may support functional recovery. Additional research is needed to identify optimal patients for therapy and to investigate the impact of oxandrolone in this population.</description><subject>Adult</subject><subject>anabolic agents</subject><subject>Anabolic Agents - therapeutic use</subject><subject>critical illness</subject><subject>extracorporeal membrane oxygenation</subject><subject>Extracorporeal Membrane Oxygenation - adverse effects</subject><subject>Extracorporeal Membrane Oxygenation - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Immune Tolerance - drug effects</subject><subject>Inflammation - etiology</subject><subject>Inflammation - prevention & control</subject><subject>Male</subject><subject>Metabolism - drug effects</subject><subject>Muscle Proteins - metabolism</subject><subject>nitrogen balance</subject><subject>Nursing</subject><subject>nutrition support</subject><subject>Nutritional Support</subject><subject>oxandrolone</subject><subject>Oxandrolone - therapeutic use</subject><subject>Respiratory Insufficiency - therapy</subject><subject>Young Adult</subject><issn>0884-5336</issn><issn>1941-2452</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEtLA0EQhAdRNEYP_gGZox5Wex4be71JiA-IRvCBt2V2tiMrm5k4k2jy7x1N9Oah6ab5qiiKsQMBJwJAnjo7TYfu4QbriEKLTOpcbrIOIOosV6q3w3ZjfAMQqM5wm-0oCZjeqsNeRgvj6uBb74g3jt-bWUNuFrl3_Jmc_0gzj3ywmAVjfZj6QKbltzSpgkmK0WL5Si5pvDvnF7xvIvEHCg3FPbY1Nm2k_fXusqfLwWP_OhuOrm76F8PMKpljhmOBSEAopAJd2xoKk2sEq4q8B1QVgKKGWpIsxlblItc9XRNiVUmLBkF12dHKdxr8-5zirJw00VLbpngpeSk1QC5lIXRCj1eoDT7GQONyGpqJCctSQPldZJmKLH-KTOzh2nZeTaj-I3-bS8DpCvhsWlr-71Te9e9Xll-I2Hw7</recordid><startdate>202006</startdate><enddate>202006</enddate><creator>Pelekhaty, Stacy L.</creator><creator>Pajoumand, Mehrnaz</creator><creator>Omanwa, Kristen S.</creator><creator>Galvagno Jr, Samuel M.</creator><creator>Lantry, James H.</creator><creator>Deatrick, Kristopher B.</creator><creator>Cornachione, Christopher R.</creator><creator>Menaker, Jay</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8060-5389</orcidid></search><sort><creationdate>202006</creationdate><title>Oxandrolone in Patients on Venovenous Extracorporeal Membrane Oxygenation: A Case Series</title><author>Pelekhaty, Stacy L. ; 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The anabolic steroid oxandrolone may improve the metabolic aberrations of PICS. We report our experience with 3 patients on VV ECMO who received oxandrolone after demonstrating refractory catabolism on serial nitrogen balance (NB) studies or persistent weakness. Patients in cases 1 and 3 were started on oxandrolone on VV ECMO days 45 and 29, respectively, for negative NB despite nutrition optimization. The case 2 patient started oxandrolone for persistent weakness 68 days after cannulation. All patients demonstrated improvements in NB results. One patient developed mild transaminitis while on oxandrolone, which did not alter his medication course and resolved after the medication was discontinued. The impact of oxandrolone on functional capacity varied between patients. Oxandrolone may be beneficial in persistently catabolic VV ECMO patients to improve NB results. In some patients, this may support functional recovery. 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| subjects | Adult anabolic agents Anabolic Agents - therapeutic use critical illness extracorporeal membrane oxygenation Extracorporeal Membrane Oxygenation - adverse effects Extracorporeal Membrane Oxygenation - methods Female Humans Immune Tolerance - drug effects Inflammation - etiology Inflammation - prevention & control Male Metabolism - drug effects Muscle Proteins - metabolism nitrogen balance Nursing nutrition support Nutritional Support oxandrolone Oxandrolone - therapeutic use Respiratory Insufficiency - therapy Young Adult |
| title | Oxandrolone in Patients on Venovenous Extracorporeal Membrane Oxygenation: A Case Series |
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