The Effect of Extracorporeal Membrane Oxygenation on the Pharmacokinetics of Dexmedetomidine Hydrochloride

Tao Wang; Huifang Zhang; Rui Tian; Liu Rong; Kaige Yang; Yan Wang; Ruilan Wang

doi:10.1053/j.jvca.2024.12.029

The Effect of Extracorporeal Membrane Oxygenation on the Pharmacokinetics of Dexmedetomidine Hydrochloride

J Cardiothorac Vasc Anesth. 2024 Dec 18:S1053-0770(24)01002-4. doi: 10.1053/j.jvca.2024.12.029. Online ahead of print.

Authors

Tao Wang¹, Huifang Zhang², Rui Tian², Liu Rong², Kaige Yang³, Yan Wang³, Ruilan Wang⁴

Affiliations

¹ Department of Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, 200080, China; Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, 200080, China.
² Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, 200080, China.
³ School of Pharmacy, Shanghai Jiao Tong University, Shanghai 200240, China.
⁴ Department of Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, 200080, China; Department of Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, 200080, China. Electronic address: [email protected].

PMID: 39779430
DOI: 10.1053/j.jvca.2024.12.029

Abstract

Objectives: Our objective was to explore the effects of extracorporeal membrane oxygenation (ECMO) on the pharmacokinetics of dexmedetomidine hydrochloride via vitro and in vivo experiments DESIGN: A single-center animal investigation.

Setting: An experimental animal facility in a tertiary hospital.

Participants: Eighteen male Landrace pigs.

Interventions: For the in vitro experiment, ECMO circuits were primed with whole blood solutions of dexmedetomidine at different concentrations and ran ex vivo. The adsorption rates of dexmedetomidine hydrochloride in ECMO circuits and control glass tubes were compared at 60 minutes, 5 hours, and 10 hours after the start of the in vitro experiment. In the in vivo experiment, 12 Landrace pigs were randomly allocated to the venovenous ECMO group or the control group. Dexmedetomidine hydrochloride (1 μg/kg) was administered to both groups. Blood samples were collected at 0 minutes, 5 minutes, 10 minutes, 15 minutes, 20 minutes, 30 minutes, 45 minutes, 60 minutes, 90 minutes, 2 hours, 3 hours, 5 hours, 7 hours, and 10 hours after administration. The plasma concentrations of dexmedetomidine were measured, and pharmacokinetic analysis was conducted in both groups.

Measurements and main results: The results revealed no significant difference in adsorption rates of dexmedetomidine hydrochloride in ECMO circuits at 60 minutes and 5 hours, but differences were observed at 10 hours. In vivo experiment, pharmacokinetic analysis revealed no significant difference in the area under the curve (AUC_0-t), AUC_0-∞, distribution half-life, elimination half-life, clearance, apparent volume of distribution, mean residence time or peak drug concentrations between the 2 groups (p > 0.05).

Conclusions: The ECMO circuit had an adsorption effect on dexmedetomidine hydrochloride, but this effect was not sufficient to impact the in vivo pharmacokinetics of dexmedetomidine significantly. The effect of ECMO on the pharmacokinetics of dexmedetomidine hydrochloride was not significant.

Keywords: dexmedetomidine hydrochloride; extracorporeal membrane oxygenation; pharmacokinetics.