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ID 56645
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Author
Iida, Atsuyoshi Department of Emergency and Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Naito, Hiromichi Department of Emergency and Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Yorifuji, Takashi Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science
Zamami, Yoshito Department of Clinical Pharmacy, Institute of Biomedical Sciences, Tokushima University Graduate School
Yamada, Akane Department of Pharmacy, Okayama University Hospital
Koga, Tadashi Drug Safety Research Laboratories, Shin Nippon Biomedical Laboratories, Ltd.
Imai, Toru Department of Pharmacy, Nihon University Itabashi Hospital
Sendo, Toshiaki Department of Pharmacy, Okayama University Hospital
Nakao, Atsunori Department of Emergency and Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Ichiba, Shingo Department of Surgical Intensive Care Medicine, Nippon Medical School Hospital
Abstract
Sedatives are administered during extracorporeal membrane oxygenation (ECMO) therapy to ensure patient safety, reduce the metabolic rate and correct the oxygen supply-demand balance. However, the concentrations of sedatives can be decreased due to absorption into the circuit. This study examined factors affecting the absorption of a commonly used sedative, midazolam (MDZ). Using multiple ex vivo simulation models, three factors that may influence MDZ levels in the ECMO circuit were examined: polyvinyl chloride (PVC) tubing in the circuit, use of a membrane oxygenator in the circuit, and heparin coating of the circuit. We also assessed changes in drug concentration when MDZ was re-injected in a circuit. The MDZ level decreased to approximately 60% of the initial concentration in simulated circuits within the first 30 minutes. The strongest factor in this phenomenon was contact with the PVC tubing. Membrane oxygenator use tended to increase MDZ loss, whereas heparin circuit coating had no influence on MDZ absorption. Similar results were obtained when a second dose of MDZ was injected to the second-use circuits.
Keywords
sedatives
ECMO
polyvinyl chloride
pharmacokinetics
pharmacodynamics
Amo Type
Original Article
Publication Title
Acta Medica Okayama
Published Date
2019-04
Volume
volume73
Issue
issue2
Publisher
Okayama University Medical School
Start Page
101
End Page
107
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
English
Copyright Holders
CopyrightⒸ 2019 by Okayama University Medical School
File Version
publisher
Refereed
True
PubMed ID