Propofol beyond use dating
As a result of drug sequestration and increased volume of distribution, the extracorporeal membrane oxygenation (ECMO) procedure might lead to a decrease in drug concentrations during a patient’s treatment.
The aim of this study was to evaluate sedative, antibiotic and immunosuppressive drug loss in ECMO circuit using ECMO circuit primed with whole human blood.
Data on vancomycin concentrations reported in ECMO are controversial.
A polypropylene tube containing human whole blood was spiked with the propofol stock solution to obtain a concentration of 2 μg/L.These observations suggest that more data are needed to better determine changes in drug concentrations of vancomycin in an ECMO circuit.Immunosuppressive agents, such as cyclosporine, are defined by a narrow therapeutic window and low serum concentrations of these drugs might lead to acute graft rejection.These data might help intensive care unit physicians planning clinical trials with a final objective to better adapt doses of these drugs while treating critically ill ECMO patients. Pharmacokinetics of drugs administered during ECMO is complex notably due to a larger volume of distribution in ECMO-treated patients and also to the adsorption of drugs on the PVC tubing and/or the membrane oxygenator leading to an increase in drug clearance [This study was an experimental study and did not include any patients.Thus, it needed no ethical approval and no patient consent was needed.