Interaction of milrinone with extracorporeal life support
Background: Milrinone is commonly prescribed to critically ill patients who need extracorporeal life support such as extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). Currently, the effect of ECMO and CRRT on the disposition of milrinone is unknown. Methods:...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
EDP Sciences
2024-12-01
|
| Series: | The Journal of ExtraCorporeal Technology |
| Subjects: | |
| Online Access: | https://ject.edpsciences.org/articles/ject/full_html/2024/04/ject240005/ject240005.html |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841554704334585856 |
|---|---|
| author | Whelan Aviva J. Mim Sabiha Hunt J. Porter McKnite Autumn M. Green Danielle J. Imburgia Carina E. Momper Jeremiah D. Stitt Gideon Watt Kevin M. |
| author_facet | Whelan Aviva J. Mim Sabiha Hunt J. Porter McKnite Autumn M. Green Danielle J. Imburgia Carina E. Momper Jeremiah D. Stitt Gideon Watt Kevin M. |
| author_sort | Whelan Aviva J. |
| collection | DOAJ |
| description | Background: Milrinone is commonly prescribed to critically ill patients who need extracorporeal life support such as extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). Currently, the effect of ECMO and CRRT on the disposition of milrinone is unknown. Methods: Ex vivo ECMO and CRRT circuits were primed with human blood and then dosed with milrinone to study drug extraction by the circuits. Milrinone percent recovery over time was calculated to determine circuit component interaction with milrinone. Results: Milrinone did not exhibit measurable interactions with the ECMO circuit, however, CRRT cleared 99% of milrinone from the experimental circuit within the first 2 hours. Conclusion: Milrinone dosing adjustments are likely required in patients who are supported with CRRT while dosing adjustments for ECMO based on these ex-vivo results are likely unnecessary. These results will help improve the safety and efficacy of milrinone in patients requiring ECMO and CRRT. Due to the limitations of ex-vivo experiments, future studies of milrinone exposure with ECLS should include patient circuit interactions as well as the physiology of critical illness. |
| format | Article |
| id | doaj-art-60fab62910fa449ba95eb8532c1020e6 |
| institution | Kabale University |
| issn | 0022-1058 2969-8960 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | EDP Sciences |
| record_format | Article |
| series | The Journal of ExtraCorporeal Technology |
| spelling | doaj-art-60fab62910fa449ba95eb8532c1020e62025-01-08T11:00:21ZengEDP SciencesThe Journal of ExtraCorporeal Technology0022-10582969-89602024-12-0156416717310.1051/ject/2024014ject240005Interaction of milrinone with extracorporeal life supportWhelan Aviva J.0https://orcid.org/0000-0001-8968-3183Mim Sabiha1https://orcid.org/0009-0005-9359-8527Hunt J. Porter2https://orcid.org/0000-0003-3503-8124McKnite Autumn M.3https://orcid.org/0000-0001-7985-2991Green Danielle J.4Imburgia Carina E.5Momper Jeremiah D.6Stitt Gideon7https://orcid.org/0000-0001-5269-214XWatt Kevin M.8Division of Clinical Pharmacology, Department of Pediatrics, University of UtahPharmacometric Research Group, Department of Pharmacy, Uppsala UniversityDivision of Clinical Pharmacology, Department of Pediatrics, University of UtahDepartment of Pharmacology and Toxicology, University of UtahDivision of Clinical Pharmacology, Department of Pediatrics, University of UtahDivision of Clinical Pharmacology, Department of Pediatrics, University of UtahSkaggs School of Pharmacy and Pharmaceutical Sciences, University of California San DiegoDivision of Clinical Pharmacology, Department of Pediatrics, University of UtahDivision of Clinical Pharmacology, Department of Pediatrics, University of UtahBackground: Milrinone is commonly prescribed to critically ill patients who need extracorporeal life support such as extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). Currently, the effect of ECMO and CRRT on the disposition of milrinone is unknown. Methods: Ex vivo ECMO and CRRT circuits were primed with human blood and then dosed with milrinone to study drug extraction by the circuits. Milrinone percent recovery over time was calculated to determine circuit component interaction with milrinone. Results: Milrinone did not exhibit measurable interactions with the ECMO circuit, however, CRRT cleared 99% of milrinone from the experimental circuit within the first 2 hours. Conclusion: Milrinone dosing adjustments are likely required in patients who are supported with CRRT while dosing adjustments for ECMO based on these ex-vivo results are likely unnecessary. These results will help improve the safety and efficacy of milrinone in patients requiring ECMO and CRRT. Due to the limitations of ex-vivo experiments, future studies of milrinone exposure with ECLS should include patient circuit interactions as well as the physiology of critical illness.https://ject.edpsciences.org/articles/ject/full_html/2024/04/ject240005/ject240005.htmlmilrinoneextracorporeal life support (ecls)extracorporeal membrane oxygenation (ecmo)continuous renal replacement therapy (crrt) |
| spellingShingle | Whelan Aviva J. Mim Sabiha Hunt J. Porter McKnite Autumn M. Green Danielle J. Imburgia Carina E. Momper Jeremiah D. Stitt Gideon Watt Kevin M. Interaction of milrinone with extracorporeal life support The Journal of ExtraCorporeal Technology milrinone extracorporeal life support (ecls) extracorporeal membrane oxygenation (ecmo) continuous renal replacement therapy (crrt) |
| title | Interaction of milrinone with extracorporeal life support |
| title_full | Interaction of milrinone with extracorporeal life support |
| title_fullStr | Interaction of milrinone with extracorporeal life support |
| title_full_unstemmed | Interaction of milrinone with extracorporeal life support |
| title_short | Interaction of milrinone with extracorporeal life support |
| title_sort | interaction of milrinone with extracorporeal life support |
| topic | milrinone extracorporeal life support (ecls) extracorporeal membrane oxygenation (ecmo) continuous renal replacement therapy (crrt) |
| url | https://ject.edpsciences.org/articles/ject/full_html/2024/04/ject240005/ject240005.html |
| work_keys_str_mv | AT whelanavivaj interactionofmilrinonewithextracorporeallifesupport AT mimsabiha interactionofmilrinonewithextracorporeallifesupport AT huntjporter interactionofmilrinonewithextracorporeallifesupport AT mckniteautumnm interactionofmilrinonewithextracorporeallifesupport AT greendaniellej interactionofmilrinonewithextracorporeallifesupport AT imburgiacarinae interactionofmilrinonewithextracorporeallifesupport AT momperjeremiahd interactionofmilrinonewithextracorporeallifesupport AT stittgideon interactionofmilrinonewithextracorporeallifesupport AT wattkevinm interactionofmilrinonewithextracorporeallifesupport |