体外生命支持和低温对危重症婴儿和儿童药物处置的影响。
The impact of extracorporeal life support and hypothermia on drug disposition in critically ill infants and children.
机构信息
Department of Pediatric Surgery, Intensive Care, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
出版信息
Pediatr Clin North Am. 2012 Oct;59(5):1183-204. doi: 10.1016/j.pcl.2012.07.013. Epub 2012 Aug 29.
Abstract
Extracorporeal membrane oxygenation (ECMO) support is an established lifesaving therapy for potentially reversible respiratory or cardiac failure. In 10% of all pediatric patients receiving ECMO, ECMO therapy is initiated during or after cardiopulmonary resuscitation. Therapeutic hypothermia is frequently used in children after cardiac arrest, despite the lack of randomized controlled trials that show its efficacy. Hypothermia is frequently used in children and neonates during cardiopulmonary bypass (CPB). By combining data from pharmacokinetic studies in children on ECMO and CPB and during hypothermia, this review elucidates the possible effects of hypothermia during ECMO on drug disposition.
摘要
体外膜肺氧合（ECMO）支持是一种已确立的救生治疗方法，适用于潜在可逆转的呼吸或心脏衰竭。在所有接受 ECMO 的儿科患者中，有 10%的患者在心肺复苏期间或之后开始接受 ECMO 治疗。尽管缺乏随机对照试验证明其疗效，但在心脏骤停后，经常在儿童中使用低温治疗。在体外循环（CPB）期间，低温治疗经常在儿童和新生儿中使用。通过结合 ECMO 和 CPB 以及低温期间儿童药代动力学研究的数据，本综述阐明了 ECMO 期间低温对药物处置的可能影响。
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