Interaction of Milrinone with Extracorporeal Life Support
Author Information
Author(s): Whelan Aviva J., Mim Sabiha, Hunt J. Porter, McKnite Autumn M., Green Danielle J., Imburgia Carina E., Momper Jeremiah D., Stitt Gideon, Watt Kevin M.
Primary Institution: University of Utah
Hypothesis
Milrinone will likely be readily filtered by CRRT and adsorb minimally to ECMO circuits.
Conclusion
Milrinone dosing adjustments are likely required in patients who are supported with CRRT, while dosing adjustments for ECMO based on these ex-vivo results are likely unnecessary.
Supporting Evidence
- Milrinone was minimally extracted by the ECMO circuit with a mean recovery of 100%.
- Milrinone was rapidly extracted by the CRRT circuit with concentrations below the lower limit of quantitation by 3 hours.
- The average clearance of milrinone calculated from the three ex vivo circuits was 9.45 L/h/70 kg.
Takeaway
Milrinone is a medicine that helps sick patients, but it gets removed quickly by a special machine called CRRT, so doctors might need to give more of it. However, it doesn't stick to another machine called ECMO, so they probably don't need to change the dose for that.
Methodology
Ex vivo ECMO and CRRT circuits were primed with human blood and dosed with milrinone to study drug extraction by the circuits.
Potential Biases
The study was IRB exempt and did not include human subjects, which may limit the applicability of the findings.
Limitations
The study only included a single bolus dose of milrinone and used only one type of ECMO and CRRT circuit components, making it difficult to generalize to other circuits.
Participant Demographics
Critically ill patients requiring ECMO and CRRT.
Statistical Information
P-Value
p ≤ 0.001
Statistical Significance
p ≤ 0.001
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website