Population Pharmacokinetics of Phenobarbital in Neonates and Infants on Extracorporeal Membrane Oxygenation and the Influence of Concomitant Renal Replacement Therapy.

摘要: The objective of this study was to describe the pharmacokinetics (PK) intravenous phenobarbital in neonates and infants on extracorporeal membrane oxygenation (ECMO) provide dosing recommendations population. We performed a retrospective single-center PK ECMO between January 1, 2014, December 31, 2018. developed population model using nonlinear mixed-effects modeling, simulations final parameters, determined optimal based attainment peak trough concentrations 20 40 mg/L. included 35 subjects with median (range) age weight 14 days (1-154 days) 3.4 kg (1.6-8.1 kg), respectively. A total 194 samples were analysis. Five children (14%) contributing 30 (16%) supported by continuous venovenous hemodiafiltration (CVVHDF). 1-compartment best described data. Typical clearance volume distribution for 3.4-kg infant 0.038 L/h 3.83 L, Clearance increased CVVHDF. Although ECMO, CVVHDF 6-fold higher than without In typical subjects, loading dose mg/kg/dose followed maintenance doses 6-7 mg/kg/day administered as divided every 12 hours reached goal concentrations. Age did not impact recommendations. However, needed strongly recommend therapeutic drug monitoring renal replacement therapy (excluding slow ultrafiltration) while ECMO.