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.
Dagan
O
O
Department of Critical Care, Hospital for Sick Children, Toronto, ON, Canada.
Klein
J
J
Bohn
D
D
Koren
G
G
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