Protein-bound drugs are prone to sequestration in the ECMO circuit

Kiran Shekar, Jason A Roberts, Charles I Mcdonald, Sussan Ghassabian, Chris Anstey, Steven C Wallis, Daniel V Mullany , Yoke L Fung , John F Fraser

Introduction: Vital drugs may be degraded or sequestered in extracorporeal membrane oxygenation (ECMO) circuits, with lipophilic drugs considered to be particularly vulnerable. However, the circuit effects on protein-bound drugs have not been fully elucidated. The aim of this experimental study was to investigate the influence of plasma protein binding on drug disposition in ex vivo ECMO circuits.