ArticleIntensive care medicine2010
Determinants of drug absorption in different ECMO circuits.
Article in Intensive care medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
110 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Impact of Extracorporeal Membrane Oxygenation Life Support on Vancomycin Population Pharmacokinetics in Critical Illness: A Systematic Review.Clinical drug investigation · 2025Pooled it
- Pharmacokinetics of Commonly Used Antimicrobials in Critically Ill Pediatric Patients During Extracorporeal Membrane Oxygenation: A Systematic Review.Paediatric drugs · 2023Pooled it
- Pooled it
- Population Pharmacokinetics of Intravenous Infusion of Hydromorphone in Critically Ill Patients Supported by Extracorporeal Membrane Oxygenation.Clinical and translational science · 2026Trial
- Population Pharmacokinetics and Target Attainment of Allopurinol and Oxypurinol Before, During, and After Cardiac Surgery with Cardiopulmonary Bypass in Neonates with Critical Congenital Heart Disease.Clinical pharmacokinetics · 2024Trial
- Influence of the ECMO circuit on the concentration of nutritional supplements.Scientific reports · 2020Trial
- Population pharmacokinetics of remifentanil in critically ill patients receiving extracorporeal membrane oxygenation.Scientific reports · 2017Trial
- Sedation Management in Children Supported on Extracorporeal Membrane Oxygenation for Acute Respiratory Failure.Critical care medicine · 2017Trial
- Fluconazole population pharmacokinetics and dosing for prevention and treatment of invasive Candidiasis in children supported with extracorporeal membrane oxygenation.Antimicrobial agents and chemotherapy · 2015Trial
- Tigecycline pharmacokinetics in critically ill patients receiving extracorporeal membrane oxygenation: a prospective multicentre pilot study.BMC anesthesiology · 2026Observational
- Comparison of Midazolam Plasma Concentrations in ARDS Patients with and Without ECMO Support-Prospective Observational Pilot Study.Life (Basel, Switzerland) · 2026Article
- Population Pharmacokinetics of Ticagrelor during Veno-Arterial ECMO in Acute Coronary Syndrome: Model-Informed Dosing Simulations.Clinical pharmacology and therapeutics · 2026Observational
- Kinetics of Sevoflurane Vaporized Directly in Extracorporeal Membrane Oxygenators-Ex Vivo Findings and Pharmacokinetic/Pharmacodynamic Simulations.European journal of drug metabolism and pharmacokinetics · 2026Article
- Fentanyl Utilization During Extracorporeal Membrane Oxygenation and Risk of Methadone Treatment Among Pediatric ECMO Survivors.Pediatric surgery international · 2026Article
- Impact of extracorporeal circuits on systemic drug levels - a scoping review.Journal of anesthesia, analgesia and critical care · 2026Review
- PEGylation of Propofol Reduces Its Adsorption to Extracorporeal Membrane Oxygenator (ECMO) Components.Pharmaceutical research · 2025Article
- Effects of Extracorporeal Membrane Oxygenation Circuits on Drug Sequestration: A Review of Ex Vivo Experiments.Journal of clinical medicine · 2025Review
- The Impact of an Ex Vivo Pediatric Extracorporeal Membrane Oxygenation Circuit on Sequestration of Antimicrobials.Critical care explorations · 2025Article
- Sedation management and processed EEG-based solutions during venovenous extracorporeal membrane oxygenation: a narrative review of key challenges and potential benefits.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025Review
- Clearance of Amlodipine, Fentanyl, Fluconazole, Methylprednisolone, and Midazolam by Continuous Renal Replacement Circuits.ASAIO journal (American Society for Artificial Internal Organs : 1992) · 2025Article
50 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this in vitro study was to evaluate potential determinants of drug loss in different ECMO circuits.
methodsMidazolam, morphine, fentanyl, paracetamol, cefazolin, meropenem and vancomycin were injected into three neonatal roller pump, two paediatric roller pump and two clinically used neonatal roller pump circuits, all with a silicone membrane, and two neonatal centrifugal pump circuits with polypropylene hollow-fibre membranes. Serial blood samples were taken from a post-oxygenator site. Drug recovery was calculated as the ratio between the determined and the theoretical maximum concentration. The latter was obtained by dividing dose by theoretical circuit volume.
resultsAverage drug recoveries at 180 min in three neonatal silicone membrane roller pump circuits were midazolam 0.62%, morphine 23.9%, fentanyl 0.35%, paracetamol 34.0%, cefazolin 84.3%, meropenem 82.9% and vancomycin 67.8%. There was a significant correlation between the lipophilicity of the drug expressed as log P and the extent of drug absorption, p < 0.001. The recovery of midazolam and fentanyl in centrifugal pump circuits with hollow-fibre membrane oxygenator was significantly higher compared to neonatal roller pump circuits with silicone membranes: midazolam 63.4 versus 0.62%, fentanyl 33.8 versus 0.35%, p < 0.001. Oxygenator size and used circuits do not significantly affect drug losses.
conclusionsSignificant absorption of drugs occurs in the ECMO circuit, correlating with increased lipophilicity of the drug. Centrifugal pump circuits with hollow-fibre membrane oxygenators show less absorption for all drugs, most pronounced for lipophilic drugs. These results suggest that pharmacokinetics and hence optimal doses of these drugs may be altered during ECMO.
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