ECMO and pharmacotherapy

Increasing numbers of neonates are receiving extracorporeal membrane oxygenation (ECMO). ECMO is an invasive, lifesaving technique used to treat respiratory failure when other technologies have failed. The pharmacokinetics of various drugs administered during ECMO are unclear. Drug clearance is altered during ECMO. Evidence exists for binding of multiple drugs to the ECMO circuit tubing. Also, the administration route of medications to neonates on ECMO varies, potentially impacting drug disposition. Questions exist regarding the effect technical components of ECMO might have on drug pharmacokinetics. Because little clinical information is available, nurses must have a heightened awareness of drug effects and the potential for untoward events while administering medications to neonates receiving ECMO This article reviews what is currently known regarding ECMO and pharmacotherapy.