{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T04:13:52Z","timestamp":1783743232636,"version":"3.55.0"},"reference-count":48,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patients supported with extracorporeal membrane oxygenation (ECMO) frequently require prolonged, high\u2010intensity analgosedation because of neuromuscular blockade, pain related to procedures, and pharmacokinetic alterations. These exposures increase the risk of iatrogenic medication toxicity and withdrawal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We evaluated whether buprenorphine (BUP) use during ECMO reduced full agonist opioid exposure and improved sedation compared with matched comparators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a retrospective matched case\u2013control cohort design among ECMO patients in a cardiovascular intensive care unit, we contrasted 30 patients treated with BUP versus 30 comparator patients not treated with BUP (NO\u2010BUP) matched using an a priori deterministic hierarchy. Comparisons were anchored to two matched time points: (i) the day before BUP exposure and (ii) the day after attaining the full therapeutic BUP dose; NO\u2010BUP comparators were assessed on the analogous ECMO days. The primary outcome was the between\u2010group difference in change in daily intravenous morphine milligram equivalents (MME) across this time period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Each cohort included 27 venovenous and three venoarterial ECMO patients. Demographics and illness severity did not differ between groups. Groups significantly differed in MME change scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) with the BUP cohort decreasing significantly (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) from 184.1 (interquartile range [IQR] 70.2\u2013367.2) to 0.0 (IQR 0.0\u201311.6) median MME whereas NO\u2010BUP comparators nonsignificantly decreased (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.517) from 230.8 (IQR 153.3\u2013567.0) to 177.2 (IQR 85.3\u2013663.1). Groups also differed (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031) in time in target RASS range (\u22122 to 0); the BUP cohort significantly improved from 53.9% to 91.2% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) whereas NO\u2010BUP comparators nominally improved from 37.8% to 46.1% (\n                      <jats:italic>p\u2009=<\/jats:italic>\n                      \u20090.275). In the BUP cohort, there was no precipitated withdrawal, opioid\u2010induced constipation, or respiratory depression. Rates of tracheostomy, mortality, and extubation before decannulation did not differ significantly.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BUP initiation among ECMO patients was feasible and associated with a marked reduction in full agonist opioid exposure and improved light\u2010sedation target attainment. These findings are hypothesis\u2010generating given the retrospective design and potential residual confounding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/phar.70177","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T05:10:29Z","timestamp":1781154629000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Buprenorphine Initiation During Extracorporeal Membrane Oxygenation Decreases Sedative and Opioid Exposure: A Retrospective Matched Case\u2010Control Study"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9349-0261","authenticated-orcid":false,"given":"David K.","family":"Carroll","sequence":"first","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Emergency Medicine Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0070-7260","authenticated-orcid":false,"given":"Eric A.","family":"Woodcock","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Neurosciences Wayne State University School of Medicine  Detroit Michigan USA"},{"name":"Department of Pharmacology Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"King","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Emergency Medicine Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7837-9332","authenticated-orcid":false,"given":"Andrew R.","family":"Isaacson","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Surgery Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5968-3801","authenticated-orcid":false,"given":"Brandtly","family":"Yakey","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Emergency Medicine Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bram A.","family":"Dolcourt","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Emergency Medicine Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Wein","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Cochrane","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Surgery Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aria","family":"Darling","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Emergency Medicine Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areej M.","family":"Fares","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Surgery Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Hoover","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Surgery Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Terasaki","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Surgery Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan E.","family":"Coyle","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Surgery Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edie","family":"Chittenden","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Surgery Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Chacko","sequence":"additional","affiliation":[{"name":"Detroit Medical Center  Detroit Michigan USA"},{"name":"Department of Surgery Wayne State University School of Medicine  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9541-7321","authenticated-orcid":false,"given":"Mark K.","family":"Greenwald","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Neurosciences Wayne State University School of Medicine  Detroit Michigan USA"},{"name":"Department of Pharmacy Practice Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-017-1644-y"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/10600280211010751"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/10600280221147695"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc11679"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/10600280221126438"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medine.2022.10.013"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-020-01338-4"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2021.1928616"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTCCM-D-24-00014"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003299"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.1445"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2023.10.018"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-50508-3"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suponc.2012.05.002"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/ael051"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001588"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.20516"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-023-00686-z"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv194"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm.2020.03.05"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/51.5.439"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200108000-00007"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.22.2983"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1141980"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000001062"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2020.35.e106"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001488"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hmedic.2024.100070"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0044-1779255"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.11077"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.09.154"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2385"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1760"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X1204000411"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002702"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000658"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.01931"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-013-2830-2"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.4103\/sja.sja_822_22"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2023.03.021"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2023.10.024"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom11060816"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.17128"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2020.04.025"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40261-025-01434-x"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2008.10.003"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202010-3794OC"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001739"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.70177","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/phar.70177","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/phar.70177","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T04:01:51Z","timestamp":1783742511000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/phar.70177"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":48,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/phar.70177"],"URL":"https:\/\/doi.org\/10.1002\/phar.70177","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]},"assertion":[{"value":"2026-04-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70177"}}