ReviewJournal of anesthesia, analgesia and critical care2026
Impact of extracorporeal circuits on systemic drug levels - a scoping review.
Review in Journal of anesthesia, analgesia and critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis scoping review explores the potential effects of various extracorporeal technologies on the clearance of commonly used drugs. Understanding these interactions is essential for ensuring patient safety and treatment effectiveness. METHODS AND
resultsA comprehensive search was performed including the PubMed, Cochrane and clinicaltrials.gov databases, with additional searches of relevant reference lists. Specific keywords relating to drug removal, therapeutic drug monitoring, and individual extracorporeal circuit platforms were used including drug removal/drug elimination/drug levels AND Continuous Renal Replacement Therapy (CRRT) or Extracorporeal Membrane Oxygenation (ECMO) or Therapeutic Plasma Exchange (TPE) or Molecular Adsorbent Recirculating Systems (MARS) or CytoSorb. CytoSorb was chosen as the representative hemoadsorption platform due to it having by far the most publications on this topic. In total 2231 articles were found with 300 included in the final review. Ten articles clearly reported removal by more than one platform so were included twice. The impact on drug levels was discussed for 157 different drugs with several publications including more than one drug. Most evidence was found for CytoSorb (158 publications/72 drugs) followed by ECMO (112 publications/55 drugs). The majority of data came from single case reports (126 articles), and case series (100 articles) with 68% (203) reporting on unwanted removal of therapeutic drugs.
conclusionThe potential for drug removal by various extracorporeal therapies in critical care is an important topic worthy of serious consideration. Available evidence to support informed decision making is limited and further research to advance the current evidence base is urgently needed. Therapeutic drug monitoring remains recommended to support clinical decision-making to enhance patient safety when using such technologies.
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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.