Optimising drug dosing in patients receiving extracorporeal membrane oxygenation
Optimal pharmacological management during extracorporeal membrane oxygenation (ECMO) involves more than administering drugs to reverse underlying disease. ECMO is a complex therapy that should be administered in a goal-directed manner to achieve therapeutic endpoints that allow reversal of disease a...
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| Language: | English English English |
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AME Publishing Company
2018
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| Online Access: | http://irep.iium.edu.my/64990/ http://irep.iium.edu.my/64990/1/64990_Optimising%20drug%20dosing.pdf http://irep.iium.edu.my/64990/2/64990_Optimising%20drug%20dosing_SCOPUS.pdf http://irep.iium.edu.my/64990/3/64990_Optimising%20drug%20dosing_WOS.pdf |
| _version_ | 1848786310131613696 |
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| author | Cheng, Vesa Abdul Aziz, Mohd. Hafiz Roberts, Jason A. Shekar, Kiran |
| author_facet | Cheng, Vesa Abdul Aziz, Mohd. Hafiz Roberts, Jason A. Shekar, Kiran |
| author_sort | Cheng, Vesa |
| building | IIUM Repository |
| collection | Online Access |
| description | Optimal pharmacological management during extracorporeal membrane oxygenation (ECMO) involves more than administering drugs to reverse underlying disease. ECMO is a complex therapy that should be administered in a goal-directed manner to achieve therapeutic endpoints that allow reversal of disease and ECMO wean, minimisation of complications (treatment of complications when they do occur), early interruption of sedation and rehabilitation, maximising patient comfort and minimising risks of delirium. ECMO can alter both the pharmacokinetics (PK) and pharmacodynamics (PD) of administered drugs and our understanding of these alterations is still evolving. Based on available data it appears that modern ECMO circuitry probably has a less significant impact on PK when compared with critical illness itself. However, these findings need further confirmation in clinical population PK studies and such studies are underway. The altered PD associated with ECMO is less understood and more research is indicated. Until robust dosing guidelines become available, clinicians will have to rely on the principles of drug dosing in critically ill and known PK alterations induced by ECMO itself. This article summarises the PK alterations and makes preliminary recommendations on possible dosing approaches. ©Journal of Thoracic Disease. |
| first_indexed | 2025-11-14T17:07:00Z |
| format | Article |
| id | iium-64990 |
| institution | International Islamic University Malaysia |
| institution_category | Local University |
| language | English English English |
| last_indexed | 2025-11-14T17:07:00Z |
| publishDate | 2018 |
| publisher | AME Publishing Company |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | iium-649902018-07-22T03:16:12Z http://irep.iium.edu.my/64990/ Optimising drug dosing in patients receiving extracorporeal membrane oxygenation Cheng, Vesa Abdul Aziz, Mohd. Hafiz Roberts, Jason A. Shekar, Kiran RS192 Materia Medica-Pharmaceutical Technology Optimal pharmacological management during extracorporeal membrane oxygenation (ECMO) involves more than administering drugs to reverse underlying disease. ECMO is a complex therapy that should be administered in a goal-directed manner to achieve therapeutic endpoints that allow reversal of disease and ECMO wean, minimisation of complications (treatment of complications when they do occur), early interruption of sedation and rehabilitation, maximising patient comfort and minimising risks of delirium. ECMO can alter both the pharmacokinetics (PK) and pharmacodynamics (PD) of administered drugs and our understanding of these alterations is still evolving. Based on available data it appears that modern ECMO circuitry probably has a less significant impact on PK when compared with critical illness itself. However, these findings need further confirmation in clinical population PK studies and such studies are underway. The altered PD associated with ECMO is less understood and more research is indicated. Until robust dosing guidelines become available, clinicians will have to rely on the principles of drug dosing in critically ill and known PK alterations induced by ECMO itself. This article summarises the PK alterations and makes preliminary recommendations on possible dosing approaches. ©Journal of Thoracic Disease. AME Publishing Company 2018-03-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/64990/1/64990_Optimising%20drug%20dosing.pdf application/pdf en http://irep.iium.edu.my/64990/2/64990_Optimising%20drug%20dosing_SCOPUS.pdf application/pdf en http://irep.iium.edu.my/64990/3/64990_Optimising%20drug%20dosing_WOS.pdf Cheng, Vesa and Abdul Aziz, Mohd. Hafiz and Roberts, Jason A. and Shekar, Kiran (2018) Optimising drug dosing in patients receiving extracorporeal membrane oxygenation. Journal of Thoracic Disease, 10. S629-S641. ISSN 2072-1439 E-ISSN 2077-6624 http://jtd.amegroups.com/article/view/16468/13032 10.21037/jtd.2017.09.154 |
| spellingShingle | RS192 Materia Medica-Pharmaceutical Technology Cheng, Vesa Abdul Aziz, Mohd. Hafiz Roberts, Jason A. Shekar, Kiran Optimising drug dosing in patients receiving extracorporeal membrane oxygenation |
| title | Optimising drug dosing in patients receiving extracorporeal membrane oxygenation |
| title_full | Optimising drug dosing in patients receiving extracorporeal membrane oxygenation |
| title_fullStr | Optimising drug dosing in patients receiving extracorporeal membrane oxygenation |
| title_full_unstemmed | Optimising drug dosing in patients receiving extracorporeal membrane oxygenation |
| title_short | Optimising drug dosing in patients receiving extracorporeal membrane oxygenation |
| title_sort | optimising drug dosing in patients receiving extracorporeal membrane oxygenation |
| topic | RS192 Materia Medica-Pharmaceutical Technology |
| url | http://irep.iium.edu.my/64990/ http://irep.iium.edu.my/64990/ http://irep.iium.edu.my/64990/ http://irep.iium.edu.my/64990/1/64990_Optimising%20drug%20dosing.pdf http://irep.iium.edu.my/64990/2/64990_Optimising%20drug%20dosing_SCOPUS.pdf http://irep.iium.edu.my/64990/3/64990_Optimising%20drug%20dosing_WOS.pdf |