The impact of extracorporeal life support and hypothermia on drug disposition in critically ill infants and children

Wildschut, E.D.; van Saet, A.; Pokorna, P.; Ahsman, M.J.; Van den Anker, J.N.; Tibboel, D.

Pediatric Clinics of North America 59(5): 1183-1204

2012


ISSN/ISBN: 1557-8240
PMID: 23036251
DOI: 10.1016/j.pcl.2012.07.013
Accession: 056366493

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Abstract
Extracorporeal membrane oxygenation (ECMO) support is an established lifesaving therapy for potentially reversible respiratory or cardiac failure. In 10% of all pediatric patients receiving ECMO, ECMO therapy is initiated during or after cardiopulmonary resuscitation. Therapeutic hypothermia is frequently used in children after cardiac arrest, despite the lack of randomized controlled trials that show its efficacy. Hypothermia is frequently used in children and neonates during cardiopulmonary bypass (CPB). By combining data from pharmacokinetic studies in children on ECMO and CPB and during hypothermia, this review elucidates the possible effects of hypothermia during ECMO on drug disposition.