Effects of extracorporeal membrane oxygenation on morphine pharmacokinetics in infants.

Abstract

To study the effect of extracorporeal membrane oxygenation (ECMO) on the pharmacokinetics of morphine in infants. A prospective, comparative study of morphine pharmacokinetics during and after ECMO. The pediatric intensive care unit at a children's hospital. Seven infants, aged 1 day to 12 months, requiring ECMO. Infusion of morphine. Steady-state concentrations of morphine were used to generate a morphine clearance rate. Plasma clearance rate of morphine increased from 0.574 +/- 0.3 L/kg/hr to 1.058 +/- 0.727 L/kg/hr after discontinuation of ECMO (p < .01). Two infants experienced a clinical picture consistent with opioid withdrawal. Infants requiring morphine after ECMO may require higher dose rates to maintain adequate sedation.