ECMO and Continuous Renal Replacement Therapy - PPAG

Volume of Distribution• ECMO requires the addition exogenous bloodproducts to prime the circuit• Increases circulating blood volume and overallvolume of distribution• Some cases more than doubles normal blood volume• Can have effects on the volume ofdistribution of medications• More significant in neonates than in pediatricand adolescent patients• Especially significant for drugs primarilydistributed in the central compartment• Low population V dCHB prime packs• Albumin• Shown to decrease drug adsorption• An electrolyte solution and Albumin are added tocircuit after the CO 2 prime and before the bloodproduct prime• Neonatal Pac• 500 mL CMV negative PRBCs