O Dagan1, J Klein, D Bohn, G Koren. 1. Department of Critical Care, Hospital for Sick Children, Toronto, ON, Canada.
Abstract
OBJECTIVES: To study the effect of extracorporeal membrane oxygenation (ECMO) on the pharmacokinetics of morphine in infants. DESIGN: A prospective, comparative study of morphine pharmacokinetics during and after ECMO. SETTING: The pediatric intensive care unit at a children's hospital. PATIENTS: Seven infants, aged 1 day to 12 months, requiring ECMO. INTERVENTION: Infusion of morphine. MEASUREMENT AND MAIN RESULTS: Steady-state concentrations of morphine were used to generate a morphine clearance rate. Plasma clearance rate of morphine increased from 0.574 +/- 0.3 L/kg/hr to 1.058 +/- 0.727 L/kg/hr after discontinuation of ECMO (p < .01). Two infants experienced a clinical picture consistent with opioid withdrawal. CONCLUSION: Infants requiring morphine after ECMO may require higher dose rates to maintain adequate sedation.
OBJECTIVES: To study the effect of extracorporeal membrane oxygenation (ECMO) on the pharmacokinetics of morphine in infants. DESIGN: A prospective, comparative study of morphine pharmacokinetics during and after ECMO. SETTING: The pediatric intensive care unit at a children's hospital. PATIENTS: Seven infants, aged 1 day to 12 months, requiring ECMO. INTERVENTION: Infusion of morphine. MEASUREMENT AND MAIN RESULTS: Steady-state concentrations of morphine were used to generate a morphine clearance rate. Plasma clearance rate of morphine increased from 0.574 +/- 0.3 L/kg/hr to 1.058 +/- 0.727 L/kg/hr after discontinuation of ECMO (p < .01). Two infants experienced a clinical picture consistent with opioid withdrawal. CONCLUSION:Infants requiring morphine after ECMO may require higher dose rates to maintain adequate sedation.
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