The challenges of multiple organ dysfunction syndrome and extra-corporeal circuits for drug delivery in critically ill patients

摘要: The multiple organ dysfunction syndrome (MODS) is characterized by more than one system failing, especially during critical illness. MODS the leading cause of morbidity and mortality in current ICU practice; moreover, dysfunction, liver kidneys, may significantly affect pharmacokinetics (PKs) different drugs that are currently administered critically ill patients. These PK alterations either result insufficient drug concentrations to achieve desired effects or blood tissue accumulation, with development serious adverse events. use extra-corporeal circuits, such as extracorporeal membrane oxygenation (ECMO) continuous renal replacement therapy (CRRT), further contribute PKs changes this patients' population. In review, we have described main occurring all these conditions how potentially be affected. lack prospective studies on large cohorts patients makes impossible any specific recommendation regimen adjustment Nevertheless, clinicians should aware abnormalities order better understand some unexpected therapeutic issues