ArticleCritical care (London, England)2015
Can physicochemical properties of antimicrobials be used to predict their pharmacokinetics during extracorporeal membrane oxygenation? Illustrative data from ovine models.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.
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Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it, 85 citations in OpenAlex.
- Antibacterial Pharmacokinetics in Critically Ill Patients Receiving Extracorporeal Membrane Oxygenation (ECMO): A Systematic Review of Population Pharmacokinetic Studies.Clinical pharmacokinetics · 2026Pooled it
- Population Pharmacokinetics of Vancomycin in Critically Ill Adult Patients Receiving Extracorporeal Membrane Oxygenation (an ASAP ECMO Study).Antimicrobial agents and chemotherapy · 2022Trial
- Antimicrobial pharmacokinetics and stewardship in critically Ill adult patients receiving ECMO: Challenges, evidence, and future directions.JHLT open · 2026Article
- The Impact of an Ex Vivo Pediatric Extracorporeal Membrane Oxygenation Circuit on Sequestration of Antimicrobials.Critical care explorations · 2025Article
- A systematic review of adult animal models investigating ECMO use for ARDS: where to from here.Intensive care medicine experimental · 2025Review
- Individual target pharmacokinetic/pharmacodynamic attainment rates among cefepime-treated patients admitted to the ICU with hospital-acquired pneumonia with and without ECMO.Antimicrobial agents and chemotherapy · 2025Article
- Population pharmacokinetics of caspofungin in critically ill patients receiving extracorporeal membrane oxygenation-an ASAP ECMO study.Antimicrobial agents and chemotherapy · 2025Article
- A narrative review on antimicrobial dosing in adult critically ill patients on extracorporeal membrane oxygenation.Critical care (London, England) · 2024Review
- Understanding antimicrobial pharmacokinetics in critically ill patients to optimize antimicrobial therapy: A narrative review.Journal of intensive medicine · 2024Review
- Reducing hydrophobic drug adsorption in an in-vitro extracorporeal membrane oxygenation model.European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V · 2024Article
- Cefiderocol is Not Sequestered in an Ex Vivo Extracorporeal Membrane Oxygenation (ECMO) Circuit.European journal of drug metabolism and pharmacokinetics · 2023Article
- Antifungal Dosing in Critically Ill Patients on Extracorporeal Membrane Oxygenation.Clinical pharmacokinetics · 2023Review
- Sustaining Life versus Altering Life-Saving Drugs: Insights to Explain the Paradoxical Effect of Extracorporeal Membrane Oxygenation on Drugs.Journal of clinical medicine · 2023Review
- Reply to FillatreAmerican journal of respiratory and critical care medicine · 2023Article
- Adequate Antimicrobial Dosing in Critically Ill Patients Receiving Extracorporeal Membrane Oxygenation: Where to Go from Here?American journal of respiratory and critical care medicine · 2023Article
- Population Pharmacokinetics of Levosimendan and its Metabolites in Critically Ill Neonates and Children Supported or Not by Extracorporeal Membrane Oxygenation.Clinical pharmacokinetics · 2023Article
- Machines that help machines to help patients: optimising antimicrobial dosing in patients receiving extracorporeal membrane oxygenation and renal replacement therapy using dosing software.Intensive care medicine · 2022Review
- Optimization of antimicrobial treatment in sepsis.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2022Review
- Decreased isavuconazole trough concentrations in the treatment of invasive aspergillosis in an adult patient receiving extracorporeal membrane oxygenation support.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2022Article
- Population Pharmacokinetics of Caspofungin and Dose Simulations in Heart Transplant Recipients.Antimicrobial agents and chemotherapy · 2022Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionEx vivo experiments in extracorporeal membrane oxygenation (ECMO) circuits have identified octanol-water partition coefficient (logP, a marker of lipophilicity) and protein binding (PB) as key drug factors affecting pharmacokinetics (PK) during ECMO. Using ovine models, in this study we investigated whether these drug properties can be used to predict PK alterations of antimicrobial drugs during ECMO.
methodsSingle-dose PK sampling was performed in healthy sheep (HS, n = 7), healthy sheep on ECMO (E24H, n = 7) and sheep with smoke inhalation acute lung injury on ECMO (SE24H, n = 6). The sheep received eight study antimicrobials (ceftriaxone, gentamicin, meropenem, vancomycin, doripenem, ciprofloxacin, fluconazole, caspofungin) that exhibit varying degrees of logP and PB. Plasma drug concentrations were determined using validated chromatographic techniques. PK data obtained from a non-compartmental analysis were used in a linear regression model to predict PK parameters based on logP and PB.
resultsWe found statistically significant differences in pH, haemodynamics, fluid balance and plasma proteins between the E24H and SE24H groups (p < 0.001). logP had a strong positive linear relationship with steady-state volume of distribution (Vss) in both the E24H and SE24H groups (p < 0.001) but not in the HS group (p = 0.9) and no relationship with clearance (CL) in all study groups. Although we observed an increase in CL for highly PB drugs in ECMO sheep, PB exhibited a weaker negative linear relationship with both CL (HS, p = 0.01; E24H, p < 0.001; SE24H, p < 0.001) and Vss (HS, p = 0.01; E24H, p = 0.004; SE24H, p = 0.05) in the final model.
conclusionsLipophilic antimicrobials are likely to have an increased Vss and decreased CL during ECMO. Protein-bound antimicrobial agents are likely to have reductions both in CL and Vss during ECMO. The strong relationship between lipophilicity and Vss seen in both the E24H and SE24H groups indicates circuit sequestration of lipophilic drugs. These findings highlight the importance of drug factors in predicting antimicrobial drug PK during ECMO and should be a consideration when performing and interpreting population PK studies.
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