{
  "abstract": "OBJECTIVES: To determine if common antimicrobials ( n = 11) are sequestered or degraded during a pediatric extracorporeal membrane oxygenation (ECMO) simulation. DESIGN: An ex vivo model of a closed ECMO circuit was established to simulate the treatment of a 3 kg infant. A control was used to quantify spontaneous antimicrobial degradation. SETTING: University research laboratory. PARTICIPANTS: None. MAIN OUTCOMES AND MEASURES: The ECMO circuit was primed and maintained at physiologic pH and temperature for 7 hours. After baseline sampling, the antimicrobials were administered as a single bolus into the circuit. Eight plasma samples were taken from the controls and ECMO circuits over 7 hours. Antimicrobial concentrations were measured using validated high-performance liquid chromatography–tandem mass spectrometry methodology. The antimicrobial recovery was compared with baseline. Each simulation was performed in triplicate to assess simulation variability. RESULTS: The recovery mean (%) in ECMO at 7 hours for ampicillin 78%, cefotaxime 92%, flucloxacillin 72%, meropenem 81%, micafungin 72%, piperacillin 84%, and voriconazole 42% was significantly different from the baseline ( p < 0.05). The recovery in the control at 7 hours for ampicillin 83%, cefotaxime 76%, flucloxacillin 90%, gentamicin 85%, meropenem 76%, piperacillin 92%, and tazobactam 93% was also significantly different from the baseline ( p < 0.05). A significant relationship was identified in the ECMO model between the antimicrobial recovery (%) and the log partition coefficient (log p ) of the studied antimicrobials ( R 2 = 0.52; p = 0.01). No significant relationship was identified between the protein binding and antimicrobial recovery ( R 2 = 0.23; p = 0.13). CONCLUSIONS AND RELEVANCE: The lipophilicity of an antimicrobial is a predictor of antimicrobial recovery in ECMO. Concentrations were significantly reduced at 7 hours for greater than 60% of the study antimicrobials in the ECMO models. Clinical studies are required for children receiving ECMO to determine if the current dosing regimens for antimicrobials provide therapeutic concentrations.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "name": "Michele Cree"
    },
    {
      "name": "Mohd Hafiz Abdul-Aziz"
    },
    {
      "name": "Emma Haisz"
    },
    {
      "name": "Steven Wallis"
    },
    {
      "name": "Hayoung Won"
    },
    {
      "name": "Chandra Sumi"
    },
    {
      "name": "Dusan Marjanovic"
    },
    {
      "name": "Jenny Ordóñez"
    },
    {
      "name": "Luregn Schlapbach"
    },
    {
      "name": "Jason A. Roberts"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/36zgz4vmqwc4x.bib",
  "cited_by": 1,
  "doi": "10.1097/cce.0000000000001338",
  "fulltext_url": null,
  "id": "36zgz4vmqwc4x",
  "issns": [
    "2639-8028"
  ],
  "landing_url": "https://hal.science/hal-05801378v1",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "hal",
      "1.sdv.mhep"
    ],
    [
      "openalex",
      "2204|Mechanical Circulatory Support Devices"
    ]
  ],
  "openalex": "W4415711168",
  "pdf_url": "https://hal.science/hal-05801378/document",
  "pmcid": null,
  "pmid": "41166568",
  "published": "2026-10-15",
  "publisher": "Wolters Kluwer Health",
  "ris": "https://research.draconitic.com/paper/36zgz4vmqwc4x.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:57Z",
      "native_id": "hal-05801378",
      "source": "hal",
      "url": "https://hal.science/hal-05801378v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "hal:0.sdv",
      "subfield": "general"
    },
    {
      "field": "medicine",
      "origin": "hal:1.sdv.mhep",
      "subfield": "general"
    }
  ],
  "title": "The Impact of an Ex Vivo Pediatric Extracorporeal Membrane Oxygenation Circuit on Sequestration of Antimicrobials",
  "title_text": "The Impact of an Ex Vivo Pediatric Extracorporeal Membrane Oxygenation Circuit on Sequestration of Antimicrobials",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:57Z",
  "url": "https://research.draconitic.com/paper/36zgz4vmqwc4x",
  "venue": "Critical Care Explorations",
  "versions": []
}