COVID-19 Drug Treatments Are Prone to Sequestration in Extracorporeal Membrane Oxygenation Circuits: An Ex Vivo Extracorporeal Membrane Oxygenation Study.
Extracorporeal Membrane Oxygenation
/ methods
Humans
Adenosine Monophosphate
/ analogs & derivatives
Alanine
/ analogs & derivatives
COVID-19 Drug Treatment
Antibodies, Monoclonal, Humanized
/ therapeutic use
Antiviral Agents
/ pharmacokinetics
Guanidines
/ pharmacokinetics
Benzamidines
COVID-19
/ therapy
SARS-CoV-2
Adenosine
/ analogs & derivatives
Journal
ASAIO journal (American Society for Artificial Internal Organs : 1992)
ISSN: 1538-943X
Titre abrégé: ASAIO J
Pays: United States
ID NLM: 9204109
Informations de publication
Date de publication:
01 Jun 2024
01 Jun 2024
Historique:
medline:
3
6
2024
pubmed:
3
6
2024
entrez:
3
6
2024
Statut:
ppublish
Résumé
Drug treatments for coronavirus disease 2019 (COVID-19) dramatically improve patient outcomes, and although extracorporeal membrane oxygenation (ECMO) has significant use in these patients, it is unknown whether ECMO affects drug dosing. We used an ex vivo adult ECMO model to measure ECMO circuit effects on concentrations of specific COVID-19 drug treatments. Three identical ECMO circuits used in adult patients were set up. Circuits were primed with fresh human blood (temperature and pH maintained within normal limits). Three polystyrene jars with 75 ml fresh human blood were used as controls. Remdesivir, GS-441524, nafamostat, and tocilizumab were injected in the circuit and control jars at therapeutic concentrations. Samples were taken from circuit and control jars at predefined time points over 6 h and drug concentrations were measured using validated assays. Relative to baseline, mean (± standard deviation [SD]) study drug recoveries in both controls and circuits at 6 h were significantly lower for remdesivir (32.2% [±2.7] and 12.4% [±2.1], p < 0.001), nafamostat (21.4% [±5.0] and 0.0% [±0.0], p = 0.018). Reduced concentrations of COVID-19 drug treatments in ECMO circuits is a clinical concern. Remdesivir and nafamostat may need dose adjustments. Clinical pharmacokinetic studies are suggested to guide optimized COVID-19 drug treatment dosing during ECMO.
Identifiants
pubmed: 38829573
doi: 10.1097/MAT.0000000000002120
pii: 00002480-202406000-00013
doi:
Substances chimiques
remdesivir
3QKI37EEHE
Adenosine Monophosphate
415SHH325A
Alanine
OF5P57N2ZX
tocilizumab
I031V2H011
Antibodies, Monoclonal, Humanized
0
nafamostat
Y25LQ0H97D
GS-441524
1BQK176DT6
Antiviral Agents
0
Guanidines
0
Benzamidines
0
Adenosine
K72T3FS567
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
546-552Informations de copyright
Copyright © ASAIO 2023.
Déclaration de conflit d'intérêts
Disclosure: The authors have no conflicts of interest to report.
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