scholarly journals Continuous infusion chemotherapy, radiotherapy, and FDG‐PET are feasible during extracorporeal membrane oxygenation

2020 ◽  
Vol 67 (9) ◽  
Author(s):  
Seth J. Rotz ◽  
Francisco A. Almeida ◽  
Shlomo Koyfman ◽  
Sudhir Krishnan ◽  
Guramrinder Singh Thind ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Continuous Infusion ◽  
Fdg Pet ◽  
Infusion Chemotherapy ◽  
Membrane Oxygenation ◽  
Continuous Infusion Chemotherapy

Opioid withdrawal in neonates after continuous infusions of morphine or fentanyl during extracorporeal membrane oxygenation

1998 ◽  
Vol 7 (5) ◽  
pp. 364-369 ◽  
Author(s):  
LS Franck ◽  
J Vilardi ◽  
D Durand ◽  
R Powers
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Continuous Infusion ◽  
Opioid Withdrawal ◽  
Opioid Analgesia ◽  
Lower Prevalence ◽  
Membrane Oxygenation ◽  
Prospective Group

BACKGROUND: Complications of opioid analgesia include tolerance and withdrawal. OBJECTIVES: To determine the effects of morphine and fentanyl on the prevalence of withdrawal after extracorporeal membrane oxygenation. METHODS: Two groups of neonates were compared during and after extracorporeal membrane oxygenation: a prospective group receiving a continuous infusion of morphine for analgesia and sedation and a retrospective group who had received a continuous infusion of fentanyl. RESULTS: Neonates receiving morphine required significantly less supplemental analgesia (P < .001) than did neonates who had received fentanyl and had a significantly lower prevalence of withdrawal after the therapy (P = .01). Neonates receiving morphine were discharged from the hospital a mean of 9.6 days sooner (P = .01) than neonates who had received fentanyl. CONCLUSIONS: Morphine may offer marked advantages over fentanyl for providing continuous analgesia and sedation in neonates.

scholarly journals Population Pharmacokinetics of Meropenem in Plasma and Subcutis from Patients on Extracorporeal Membrane Oxygenation Treatment

2018 ◽  
Vol 62 (5) ◽  
Author(s):  
Pelle Hanberg ◽  
Kristina Öbrink-Hansen ◽  
Anders Thorsted ◽  
Mats Bue ◽  
Mikkel Tøttrup ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Continuous Infusion ◽  
Prospective Observational Study ◽  
Plasma Concentrations ◽  
Content Type ◽  
Membrane Oxygenation ◽  
Population Pk ◽  
Dosing Regimens ◽  
Subcutaneous Adipose ◽  
Ecmo Treatment

ABSTRACTThe objectives of this study were to describe meropenem pharmacokinetics (PK) in plasma and/or subcutaneous adipose tissue (SCT) in critically ill patients receiving extracorporeal membrane oxygenation (ECMO) treatment and to develop a population PK model to simulate alternative dosing regimens and modes of administration. We conducted a prospective observational study. Ten patients on ECMO treatment received meropenem (1 or 2 g) intravenously over 5 min every 8 h. Serial SCT concentrations were determined using microdialysis and compared with plasma concentrations. A population PK model of SCT and plasma data was developed using NONMEM. Time above clinical breakpoint MIC forPseudomonas aeruginosa(8 mg/liter) was predicted for each patient. The following targets were evaluated: time for which the free (unbound) concentration is maintained above the MIC of at least 40% (40%fT>MIC), 100%fT>MIC, and 100%fT>4×MIC. For all dosing regimens simulated in both plasma and SCT, 40%fT>MIC was attained. However, prolonged meropenem infusion would be needed for 100%fT>MIC and 100%fT>4×MIC to be obtained. Meropenem plasma and SCT concentrations were associated with estimated creatinine clearance (eCLCr). Simulations showed that in patients with increased eCLCr, dose increment or continuous infusion may be needed to obtain therapeutic meropenem concentrations. In conclusion, our results show that using traditional targets of 40%fT>MIC for standard meropenem dosing of 1 g intravenously every 8 h is likely to provide sufficient meropenem concentration to treat the problematic pathogenP. aeruginosafor patients receiving ECMO treatment. However, for patients with an increased eCLCr, or if more aggressive targets, like 100%fT>MIC or 100%fT>4×MIC, are adopted, incremental dosing or continuous infusion may be needed.

ACNU–cisplatin Continuous Infusion Chemotherapy as Salvage Therapy for Recurrent Glioblastomas: Phase II Study

2005 ◽  
Vol 75 (2) ◽  
pp. 173-180 ◽  
Author(s):  
Ho-Shin Gwak ◽  
Sang-Min Youn ◽  
Austin-Hyuk Kwon ◽  
Seung Hoon Lee ◽  
Jong Hyun Kim ◽  
...  
Keyword(s):  
Continuous Infusion ◽  
Phase Ii ◽  
Salvage Therapy ◽  
Phase Ii Study ◽  
Infusion Chemotherapy ◽  
Continuous Infusion Chemotherapy

Morphine pharmacokinetics during continuous infusion of morphine sulfate for infants receiving extracorporeal membrane oxygenation

1997 ◽  
Vol 25 (2) ◽  
pp. 360-364 ◽  
Author(s):  
Jeremy M. Geiduschek ◽  
Anne M. Lynn ◽  
Susan L. Bratton ◽  
John C. Sanders ◽  
Fiona H. Levy ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Continuous Infusion ◽  
Morphine Sulfate ◽  
Membrane Oxygenation

Continuous infusion chemotherapy: a critical review.

1984 ◽  
Vol 2 (11) ◽  
pp. 1289-1304 ◽  
Author(s):  
N J Vogelzang
Keyword(s):  
Continuous Infusion ◽  
Therapeutic Index ◽  
Venous Access ◽  
Chemotherapeutic Agents ◽  
Infusion Therapy ◽  
Infusion Chemotherapy ◽  
Antineoplastic Effect ◽  
Randomized Controlled Studies ◽  
Continuous Infusion Chemotherapy ◽  
The Cost

With the development of reliable drug pumps and safe long-term venous access catheters, the continuous infusion of chemotherapeutic agents has become clinically feasible. The available studies on infusion therapy with 37 antineoplastic drugs are analyzed. With the majority of agents, infusion studies have either not been performed or the completed studies have failed to demonstrate improved effectiveness over bolus therapy. In some continuous infusion studies, effectiveness has been retained but with no apparent improvement in the therapeutic index. Several other drugs such as bleomycin, cytosine arabinoside, and doxorubicin have apparent improvement in the therapeutic index when given as a continuous infusion. The improved therapeutic index of the fluorinated pyrimidines when given via continuous infusion must be explored in randomized controlled studies using malignancies other than colorectal cancer. The cost effectiveness of such studies must be carefully assessed. Since this method of administration of chemotherapeutic agents offers the potential for less toxicity and retained antineoplastic effect, such investigations are highly desirable for improved patient care.

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