title: Effect of hypothermia and extracorporeal life support on drug disposition in neonates.
abstract: Extracorporeal membrane oxygenation (ECMO) is a valuable treatment modality in neonates with reversible cardiopulmonary failure in therapy-resistant pulmonary hypertension after perinatal asphyxia, septic shock or ECMO cardiopulmonary resuscitation. Neonates with severe perinatal asphyxia are currently treated with therapeutic hypothermia to improve neurological outcome. Consequently, therapeutic hypothermia may be indicated in the neonatal ECMO population. Both ECMO and hypothermia have been associated with changes in drug disposition. However, little is known about the combined effects of these treatment modalities. This review will explore the available literature, identify possible changes in pharmacokinetics and make suggestions for future research directions.
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands. e.wildschut@erasmusmc.nl
authors.forename: Enno D
authors.initials: ED
authors.lastname: Wildschut
authors.forename: Saskia N
authors.initials: SN
authors.lastname: de Wildt
authors.forename: Ron A A
authors.initials: RA
authors.lastname: Mâthot
authors.forename: I K M
authors.initials: IK
authors.lastname: Reiss
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.forename: John
authors.initials: J
authors.lastname: Van den Anker
mesh_terms: D000701:Analgesics, Opioid / Q000493:pharmacokinetics; D016887:Cardiopulmonary Resuscitation; D015199:Extracorporeal Membrane Oxygenation; D005283:Fentanyl / Q000493:pharmacokinetics; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D007231:Infant, Newborn; D009020:Morphine / Q000493:pharmacokinetics
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D005283:Fentanyl