Effects of extracorporeal membrane oxygenation on morphine pharmacokinetics in infants

Crit Care Med. 1994 Jul;22(7):1099-101. doi: 10.1097/00003246-199407000-00008.


Objectives: To study the effect of extracorporeal membrane oxygenation (ECMO) on the pharmacokinetics of morphine in infants.

Design: A prospective, comparative study of morphine pharmacokinetics during and after ECMO.

Setting: The pediatric intensive care unit at a children's hospital.

Patients: Seven infants, aged 1 day to 12 months, requiring ECMO.

Intervention: Infusion of morphine.

Measurement and main results: Steady-state concentrations of morphine were used to generate a morphine clearance rate. Plasma clearance rate of morphine increased from 0.574 +/- 0.3 L/kg/hr to 1.058 +/- 0.727 L/kg/hr after discontinuation of ECMO (p < .01). Two infants experienced a clinical picture consistent with opioid withdrawal.

Conclusion: Infants requiring morphine after ECMO may require higher dose rates to maintain adequate sedation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Extracorporeal Membrane Oxygenation* / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Metabolic Clearance Rate
  • Morphine / administration & dosage
  • Morphine / blood
  • Morphine / pharmacokinetics*
  • Prospective Studies
  • Radioimmunoassay
  • Respiratory Distress Syndrome, Newborn / blood
  • Respiratory Distress Syndrome, Newborn / epidemiology
  • Respiratory Distress Syndrome, Newborn / therapy
  • Respiratory Insufficiency / blood
  • Respiratory Insufficiency / epidemiology
  • Respiratory Insufficiency / therapy
  • Time Factors


  • Morphine