Related Experiment Video
Updated: Nov 30, 2025

Modeling Neonatal Intraventricular Hemorrhage Through Intraventricular Injection of Hemoglobin
Published on: August 25, 2022
Impact of haemolysis on vancomycin disposition in a full-term neonate treated with extracorporeal membrane
Pavla Pokorná1,2,3, Martin Šíma1, Dick Tibboel2,3
1Department of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Introduction:
Extracorporeal membrane oxygenation (ECMO) is a lifesaving support technology for potentially reversible neonatal cardiac and/or respiratory failure. Pharmacological consequences of ECMO-induced haemolysis in neonates are not well understood.
Case Report:
We report a case report of a full-term neonate treated for congenital diaphragmatic hernia and sepsis with ECMO and with vancomycin. While the population elimination half-life of 7 h was estimated, fitting of the simulated population pharmacokinetic profile to truly observed drug concentration points resulted in the personalized value of 41 h.
Discussion:
The neonate developed ECMO-induced haemolysis with subsequent acute kidney injury resulting in prolonged drug elimination. Whole blood/serum ratio of 0.79 excluded possibility of direct increase of vancomycin serum concentration during haemolysis.
Conclusion:
Vancomycin elimination may be severely prolonged due to ECMO-induced haemolysis and acute kidney injury, while hypothesis of direct increase of vancomycin levels by releasing the drug from blood cells during haemolysis has been disproved.
Related Concept Videos
Pharmacokinetics in Pediatric Patients: Drug Excretion
Pharmacokinetics in Pediatric Patients: Drug Metabolism
Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis

