ArticleEuropean journal of drug metabolism and pharmacokinetics2026
Kinetics of Sevoflurane Vaporized Directly in Extracorporeal Membrane Oxygenators-Ex Vivo Findings and Pharmacokinetic/Pharmacodynamic Simulations.
Article in European journal of drug metabolism and pharmacokinetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Author's Reply to Peek: "Kinetics of Sevoflurane Vaporized Directly in Extracorporeal Membrane Oxygenators-Ex Vivo Findings and Pharmacokinetic/Pharmacodynamic Simulations".European journal of drug metabolism and pharmacokinetics · 2026Article
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10 authors.
Funding
Abstract
backgroundAlthough sedation is commonly used in patients undergoing venovenous extracorporeal membrane oxygenation (V-V ECMO), the use of volatile anesthetics is less frequent, and there is limited data on the pharmacokinetics/pharmacodynamics (PK/PD) of these sedatives (e.g., sevoflurane) directly vaporized into ECMO circuits. We aimed to develop a kinetic model for sevoflurane vaporized in ex vivo ECMO oxygenators to inform the design of a pilot clinical trial to evaluate the safety, feasibility, and in vivo PK/PD model of such a strategy in patients supported with V-V ECMO.
methodsWe conducted ex vivo trials using three ECMO circuits primed with Ringer's lactate, and the ECMO pump speed set to achieve a fluid flow rate of 5 L/min. Sevoflurane was vaporized at concentrations of 1-8% with sweep gas flow (SGF) rates of 1-10 L/min. We analyzed sevoflurane concentrations in the ECMO circuit using headspace gas chromatography-mass spectrometry and monitored environmental sevoflurane concentrations for safety. We used sequential PK/PD modeling to simulate clinical conditions, targeting sedation levels defined by processed electroencephalography (Patient State Index [PSI] 40-60), using pharmacodynamic parameters derived from non-ECMO populations.
resultsSevoflurane effectively crossed polymethyl pentene (PMP) membranes, rapidly reaching maximum concentrations (C
conclusionsOur ex vivo findings demonstrate the feasibility of using sevoflurane vaporized directly into ECMO circuits as a sedative strategy. These results provide a robust foundation for translating this delivery strategy into a pilot clinical trial aimed at optimizing ECMO sedation with inhaled sevoflurane in patients with severe ARDS.
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