Population pharmacokinetics of remifentanil in critically ill patients receiving extracorporeal membrane oxygenation

Seungwon Yang, Hayeon Noh, Jongsung Hahn, Byung Hak Jin, Kyoung Lok Min, Soo Kyung Bae, Jiseon Kim, Min Soo Park, Taegon Hong, Jin Wi, Min Jung Chang

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Extracorporeal membrane oxygenation (ECMO) is associated with pharmacokinetic (PK) changes of drugs. It presents considerable challenges to providing optimal dosing regimens for patients receiving ECMO. We aimed to describe the population PK of remifentanil in critically ill adult patients receiving venoartrial extracorporeal membrane oxygenation (VA-ECMO) and to identify determinants associated with altered remifentanil concentrations. The population PK model of remifentanil was developed using nonlinear mixed effects modelling (NONMEM). Fifteen adult patients who received a continuous infusion of remifentanil during VA-ECMO participated in the study. The PK of remifentanil was best described by a one-compartment model with additive and proportional residual errors. Remifentanil concentrations were affected by sex and ECMO pump speed. The final PK model included the effect of sex and ECMO pump speed on clearance is developed as followed: clearance (L/h) = 366 × 0.502sex × (ECMO pump speed/2350)2.04 and volume (L) = 41. Remifentanil volume and clearance were increased in adult patients on VA-ECMO compared with previously reported patients not on ECMO. We suggest that clinicians should consider an increased remifentanil dosing to achieve the desired level of sedation and provide a dosing regimen according to sex and ECMO pump speed.

Original languageEnglish
Article number16358
JournalScientific reports
Volume7
Issue number1
DOIs
Publication statusPublished - 2017 Dec 1

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Extracorporeal Membrane Oxygenation
Critical Illness
Pharmacokinetics
Population
remifentanil

All Science Journal Classification (ASJC) codes

  • General

Cite this

Yang, Seungwon ; Noh, Hayeon ; Hahn, Jongsung ; Jin, Byung Hak ; Min, Kyoung Lok ; Bae, Soo Kyung ; Kim, Jiseon ; Park, Min Soo ; Hong, Taegon ; Wi, Jin ; Chang, Min Jung. / Population pharmacokinetics of remifentanil in critically ill patients receiving extracorporeal membrane oxygenation. In: Scientific reports. 2017 ; Vol. 7, No. 1.
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Population pharmacokinetics of remifentanil in critically ill patients receiving extracorporeal membrane oxygenation. / Yang, Seungwon; Noh, Hayeon; Hahn, Jongsung; Jin, Byung Hak; Min, Kyoung Lok; Bae, Soo Kyung; Kim, Jiseon; Park, Min Soo; Hong, Taegon; Wi, Jin; Chang, Min Jung.

In: Scientific reports, Vol. 7, No. 1, 16358, 01.12.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Population pharmacokinetics of remifentanil in critically ill patients receiving extracorporeal membrane oxygenation

AU - Yang, Seungwon

AU - Noh, Hayeon

AU - Hahn, Jongsung

AU - Jin, Byung Hak

AU - Min, Kyoung Lok

AU - Bae, Soo Kyung

AU - Kim, Jiseon

AU - Park, Min Soo

AU - Hong, Taegon

AU - Wi, Jin

AU - Chang, Min Jung

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Y1 - 2017/12/1

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