Designing drug regimens for special intensive care unit populations

Table 10 Drug dosing considerations in adult patients receiving extracorporeal membrane oxygenation

Drug dosing recommendations for an adult on ECMO are unlikely to be evidenced-based

Data from neonatal case reports, case series or studies may not apply to adults

Data from one drug may not be applicable to another even from the same class

Drug regimen recommendations in critical care guidelines may not apply to patients on ECMO

Organ dysfunction apart from the lung and heart complicate interpretation of literature

The contribution of distinct physicochemical properties of drugs to sequestration is unclear

Hydrophilicity or lipophilicity appear to be important factors affecting pharmacokinetics

The therapeutic actions of drugs are not consistently predictable by pharmacokinetics

The design and properties of the equipment change over time with implications for dosing

The priming solution such as blood or blood-derived products may affect dosing

ECMO: Extracorporeal membrane oxygenation.