Effects of extracorporeal membrane oxygenation on morphine pharmacokinetics in infants.
OBJECTIVE
To study the effect of extracorporeal membrane oxygenation (ECMO) on the pharmacokinetics of morphine in infants.


METHODS
A prospective, comparative study of morphine pharmacokinetics during and after ECMO.


METHODS
The pediatric intensive care unit at a children's hospital.


METHODS
Seven infants, aged 1 day to 12 months, requiring ECMO.


METHODS
Infusion of morphine.


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.


CONCLUSIONS
Infants requiring morphine after ECMO may require higher dose rates to maintain adequate sedation.
Department of Critical Care, Hospital for Sick Children, Toronto, ON, Canada.
O
O
Dagan
J
J
Klein
D
D
Bohn
G
G
Koren
D015199:Extracorporeal Membrane Oxygenation / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008657:Metabolic Clearance Rate; D009020:Morphine / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D011446:Prospective Studies; D011863:Radioimmunoassay; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood / Q000453:epidemiology / Q000628:therapy; D012131:Respiratory Insufficiency / Q000097:blood / Q000453:epidemiology / Q000628:therapy; D013997:Time Factors
D009020:Morphine