ReviewClinical pharmacokinetics2023
Pharmacokinetic Alterations Associated with Critical Illness.
Review in Clinical pharmacokinetics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
79 citing papers in PubMed, 4 syntheses or guidelines pooled it, 126 citations in OpenAlex.
- How Feasible is the Use of Saliva for Antiviral Therapeutic Drug Monitoring? A Systematic Review and Analysis.Clinical pharmacokinetics · 2026Pooled it
- Drug Clearance and Dosing During CytoSorb Hemoadsorption: A Systematic Review.Critical care explorations · 2026Pooled it
- Cangrelor in critically ill patients with cardiogenic shock or post-cardiac arrest undergoing percutaneous coronary intervention: a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Pharmacokinetics of Opioid Infusions in the Adult Intensive Care Unit Setting-A Systematic Review.Clinical pharmacokinetics · 2025Pooled it
- Antiseizure medication dosing and monitoring in the intensive care unit: a practical narrative review.Intensive care medicine · 2026Review
- Mechanisms and therapeutic strategies of pyroptosis in sepsis‑induced acute lung injury (Review).International journal of molecular medicine · 2026Review
- Sustained postoperative elevation of ionized magnesium levels following cardiac surgery with magnesium-enriched cardioplegia: a prospective observational study.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2026Observational
- Real-World Comparison of Trough- and Online-Bayesian-Calculator-Derived AUCPharmaceuticals (Basel, Switzerland) · 2026Article
- Pharmacokinetics of 2 mg/kg Bupivacaine in a Rectus Abdominis Sheath Block in Horses.Journal of veterinary pharmacology and therapeutics · 2026Article
- Linezolid-induced lactic acidosis in critically ill patients: A multicentre study of incidence, severity and predictors.British journal of clinical pharmacology · 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
- Antioxidant Activity of EthanolicMolecules (Basel, Switzerland) · 2026Article
- Dexmedetomidine use in Infants undergoing Cooling due to neonatal Encephalopathy (DICE trial): safety and pharmacokinetics.Pediatric research · 2026Article
- Comparative pharmacokinetics of trimethoprim-sulfadiazine and trimethoprim-sulfamethoxazole in dogs.BMC veterinary research · 2026Article
- Population Pharmacokinetics of Voriconazole in Patients Receiving Extracorporeal Membrane Oxygenation.Pharmaceutical research · 2026Article
- From classroom to the counter: exploring knowledge, attitudes, and practices toward Down syndrome among pharmacy students and pharmacists.BMC medical education · 2026Article
- Pharmacokinetics and Exploratory Exposure-Response Analysis of Chikusetsusaponin IVa in Myocardial Ischemia/Reperfusion-Injured Rats.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Melatonin in the ICU: is it futility or flawed framing?Intensive care medicine · 2026Article
- Pharmacokinetics of dolutegravir, tenofovir and lamivudine during venous-venous extracorporeal membrane oxygenation (VV-ECMO): A case report.British journal of clinical pharmacology · 2026Article
- Midazolam Dosing During CRRT: A Combined Ex Vivo and Physiologically-Based Pharmacokinetic Approach.CPT: pharmacometrics & systems pharmacology · 2026Article
19 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
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Haemodynamic, metabolic, and biochemical derangements in critically ill patients affect drug pharmacokinetics and pharmacodynamics making dose optimisation particularly challenging. Appropriate therapeutic dosing depends on the knowledge of the physiologic changes caused by the patient's comorbidities, underlying disease, resuscitation strategies, and polypharmacy. Critical illness will result in altered drug protein binding, ionisation, and volume of distribution; it will also decrease oral drug absorption, intestinal and hepatic metabolism, and renal clearance. In contrast, the resuscitation strategies and the use of vasoactive drugs may oppose these effects by leading to a hyperdynamic state that will increase blood flow towards the major organs including the brain, heart, kidneys, and liver, with the subsequent increase of drug hepatic metabolism and renal excretion. Metabolism is the main mechanism for drug clearance and is one of the main pharmacokinetic processes affected; it is influenced by patient-specific factors, such as comorbidities and genetics; therapeutic-specific factors, including drug characteristics and interactions; and disease-specific factors, like organ dysfunction. Moreover, organ support such as mechanical ventilation, renal replacement therapy, and extracorporeal membrane oxygenation may contribute to both inter- and intra-patient variability of drug pharmacokinetics. The combination of these competing factors makes it difficult to predict drug response in critically ill patients. Pharmacotherapy targeted to therapeutic goals and therapeutic drug monitoring is currently the best option for the safe care of the critically ill. The aim of this paper is to review the alterations in drug pharmacokinetics associated with critical illness and to summarise the available evidence.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.