Oxandrolone in Patients on Venovenous Extracorporeal Membrane Oxygenation: A Case Series. (21st February 2020)

• Record Type: Journal Article
• Authors: Pelekhaty, Stacy L.; Pajoumand, Mehrnaz; Omanwa, Kristen S.; Galvagno Jr, Samuel M.; Lantry, James H.; Deatrick, Kristopher B.; Cornachione, Christopher R.; Menaker, Jay
• Is Part Of: Nutrition in clinical practice. Volume 35:Number 3(2020)
• Page Start: 514
• Page End: 521
• Publication Date: 2020-02-21
• Subjects: anabolic agents -- critical illness -- extracorporeal membrane oxygenation -- nitrogen balance -- nutrition support -- oxandrolone; Nutrition -- Periodicals; Diet therapy -- Periodicals; Artificial feeding -- Periodicals; 615.854
• DOI: 10.1002/ncp.10468
• Languages: English
• ISSNs: 0884-5336

Abstract

Abstract: 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.