title: The impact of extracorporeal life support and hypothermia on drug disposition in critically ill infants and children.
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.
authors.affiliation: Department of Pediatric Surgery, Intensive Care, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands. e.wildschut@erasmusmc.nl
authors.forename: Enno D
authors.initials: ED
authors.lastname: Wildschut
authors.forename: Annewil
authors.initials: A
authors.lastname: van Saet
authors.forename: Pavla
authors.initials: P
authors.lastname: Pokorna
authors.forename: Maurice J
authors.initials: MJ
authors.lastname: Ahsman
authors.forename: John N
authors.initials: JN
authors.lastname: Van den Anker
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
mesh_terms: D016887:Cardiopulmonary Resuscitation; D002648:Child; D016638:Critical Illness; D016903:Drug Monitoring; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D007223:Infant; D007231:Infant, Newborn; D008020:Life Support Care / Q000379:methods*; D010599:Pharmacokinetics