ASAP ECMO: Antibiotic, Sedative and Analgesic Pharmacokinetics during Extracorporeal Membrane Oxygenation: a multi-centre study to optimise drug therapy during ECMO

Kiran Shekar; Jason A Roberts; Susan Welch; Hergen Buscher; Sam Rudham; Fay Burrows; Sussan Ghassabian; Steven C Wallis; Bianca Levkovich; Vin Pellegrino; Shay McGuinness; Rachael Parke; Eileen Gilder; Adrian G Barnett; James Walsham; Daniel V Mullany; Yoke Lin Fung; Maree T Smith; John F Fraser

doi:10.1186/1471-2253-12-29

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ASAP ECMO: Antibiotic, Sedative and Analgesic Pharmacokinetics during Extracorporeal Membrane Oxygenation: a multi-centre study to optimise drug therapy during ECMO

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ASAP ECMO: Antibiotic, Sedative and Analgesic Pharmacokinetics during Extracorporeal Membrane Oxygenation: a multi-centre study to optimise drug therapy during ECMO

Kiran Shekar, Jason A Roberts, Susan Welch, Hergen Buscher, Sam Rudham, Fay Burrows, Sussan Ghassabian, Steven C Wallis, Bianca Levkovich, Vin Pellegrino, …

BMC Anesthesiology, Vol.12, 29

2012

DOI: https://doi.org/10.1186/1471-2253-12-29

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Abstract

Background Given the expanding scope of extracorporeal membrane oxygenation (ECMO) and its variable impact on drug pharmacokinetics as observed in neonatal studies, it is imperative that the effects of the device on the drugs commonly prescribed in the intensive care unit (ICU) are further investigated. Currently, there are no data to confirm the appropriateness of standard drug dosing in adult patients on ECMO. Ineffective drug regimens in these critically ill patients can seriously worsen patient outcomes. This study was designed to describe the pharmacokinetics of the commonly used antibiotic, analgesic and sedative drugs in adult patients receiving ECMO. Methods/Design This is a multi-centre, open-label, descriptive pharmacokinetic (PK) study. Eligible patients will be adults treated with ECMO for severe cardiac and/or respiratory failure at five Intensive Care Units in Australia and New Zealand. Patients will receive the study drugs as part of their routine management. Blood samples will be taken from indwelling catheters to investigate plasma concentrations of several antibiotics (ceftriaxone, meropenem, vancomycin, ciprofloxacin, gentamicin, piperacillin-tazobactum, ticarcillin-clavulunate, linezolid, fluconazole, voriconazole, caspofungin, oseltamivir), sedatives and analgesics (midazolam, morphine, fentanyl, propofol, dexmedetomidine, thiopentone). The PK of each drug will be characterised to determine the variability of PK in these patients and to develop dosing guidelines for prescription during ECMO. Discussion The evidence-based dosing algorithms generated from this analysis can be evaluated in later clinical studies. This knowledge is vitally important for optimising pharmacotherapy in these most severely ill patients to maximise the opportunity for therapeutic success and minimise the risk of therapeutic failure.

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Title: ASAP ECMO: Antibiotic, Sedative and Analgesic Pharmacokinetics during Extracorporeal Membrane Oxygenation: a multi-centre study to optimise drug therapy during ECMO
Authors: Kiran Shekar (Author) - University of Queensland
Jason A Roberts (Author) - University of Queensland
Susan Welch (Author) - St Vincents Hospital
Hergen Buscher (Author) - St Vincents Hospital
Sam Rudham (Author) - St Vincents Hospital
Fay Burrows (Author) - St Vincents Hospital
Sussan Ghassabian (Author) - University of Queensland
Steven C Wallis (Author) - University of Queensland
Bianca Levkovich (Author) - Alfred Hospital
Vin Pellegrino (Author) - Alfred Hospital
Shay McGuinness (Author) - Auckland City Hospital, New Zealand
Rachael Parke (Author) - Auckland City Hospital, New Zealand
Eileen Gilder (Author) - Auckland City Hospital, New Zealand
Adrian G Barnett (Author) - Queensland University of Technology
James Walsham (Author) - Princess Alexandra Hospital
Daniel V Mullany (Author) - University of Queensland
Yoke Lin Fung (Author) - University of Queensland
Maree T Smith (Author) - University of Queensland
John F Fraser (Author) - University of Queensland
Publication details: BMC Anesthesiology, Vol.12, 29; 9
Publisher: BioMed Central Ltd.
Date published: 2012
DOI: 10.1186/1471-2253-12-29
ISSN: 1471-2253
Copyright note: Copyright © 2012 Shekar et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Organisation Unit: School of Health - Biomedicine; University of the Sunshine Coast, Queensland; School of Health and Sport Sciences - Legacy; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99448737702621
Output Type: Journal article

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Collaboration types: Domestic collaboration; International collaboration
Web Of Science research areas: Anesthesiology

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