Drug-Drug Interactions in Patients with Acute Respiratory Distress Syndrome

Area of Science:

• Critical Care Medicine
• Pharmacology
• Pulmonology

Background:

• Acute respiratory distress syndrome (ARDS) is a severe, inflammatory lung condition with no existing data on potential drug-drug interactions (pDDIs).
• Critically ill patients often receive multiple medications, increasing the risk of pDDIs.

Purpose of the Study:

• To analyze pDDIs in critically ill ARDS patients.
• To investigate if COVID-19 as a cause of ARDS or extracorporeal membrane oxygenation (ECMO) treatment influences pDDI occurrence.

Main Methods:

• Retrospective study of ARDS patients (≥18 years) from January 2010 to September 2021.
• Utilized the Janusmed database to identify pDDIs.
• Compared pDDI rates between COVID-19 and non-COVID-19 ARDS, and between ECMO and non-ECMO patients.

Main Results:

• Identified 2694 pDDIs in 189 patients over a median 22-day treatment duration.
• 12% of pDDIs were clinically relevant and best avoided (median rate 0.05/day).
• No significant difference in pDDIs between COVID-19 and non-COVID-19 ARDS.
• Patients on ECMO had a significantly higher rate of severe pDDIs per day.

Conclusions:

• pDDIs are frequent in ARDS patients, with most experiencing at least one clinically relevant interaction during their ICU stay.
• ECMO treatment is associated with a higher incidence of severe pDDIs in ARDS patients.
• Further research is needed to mitigate pDDI risks in this vulnerable population.