{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:53:04Z","timestamp":1747187584948,"version":"3.40.5"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T00:00:00Z","timestamp":1673827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cardiopulmonary bypass can affect the pharmacokinetics of anesthetic agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aimed to evaluate the pharmacokinetics of dexmedetomidine for infants and small children undergoing cardiac surgery with cardiopulmonary bypass based on population pharmacokinetics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 30 pediatric cardiac surgical patients in this study. After anesthetic induction with atropine (0.02\u2009mg\/kg), thiopental sodium (5\u00a0mg\/kg), and fentanyl (2\u20133\u00a0\u03bcg\/kg), we administered 1\u00a0\u03bcg\/kg of dexmedetomidine for 10\u00a0min, followed by administration of 0.5\u00a0\u03bcg\/kg of dexmedetomidine per hour during surgery. At the initiation of cardiopulmonary bypass, 1\u00a0\u03bcg\/kg of dexmedetomidine was infused over 5\u00a0min. Arterial blood was obtained at predefined time points. A pharmacokinetic model was developed using NONMEM. Theory\u2010based allometric scaling with fixed exponents was applied. Weight, age, post\u2010menstrual age, fat\u2010free mass, whether to implement cardiopulmonary bypass and temperature were explored as covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 376 blood samples were obtained from 29 children (age: 20.3\u2009\u00b1\u200919.3\u00a0months, weight: 9.7\u2009\u00b1\u20094.1\u00a0kg). A two\u2010compartment mammillary model with third compartment associated cardiopulmonary bypass procedure best explained the pharmacokinetics of dexmedetomidine. The pharmacokinetic parameter estimates (95% CI) standardized to a 70\u2010kg person were as follows: V<jats:sub>1<\/jats:sub> (L)\u00a0=\u00a031.6 (17.9\u201339.5), V<jats:sub>2<\/jats:sub> (L)\u00a0=\u00a090.1 (44.0\u2013330), Cl (L\/min)\u00a0=\u00a01.08 (0.70\u20131.25), Q (L\/min)\u00a0=\u00a02.0 (1.05\u20133.46). Volume for third compartment associated cardiopulmonary bypass procedure (L)\u00a0=\u00a039.4 (19.3\u201350.9). Clearance was not influenced by the presence of cardiopulmonary bypass in this model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When cardiopulmonary bypass is applied, the plasma concentration of dexmedetomidine decreases due to an increase in the volume of distribution, so a loading dose is required to maintain the previous concentration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14626","type":"journal-article","created":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T14:08:23Z","timestamp":1672754903000},"page":"303-311","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pharmacokinetics of dexmedetomidine in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0697-1935","authenticated-orcid":false,"given":"Eun\u2010Hee","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Seoul National University Hospital, Seoul National University College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byung\u2010Moon","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center Ulsan College of Medicine  Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pyoyoon","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Seoul National University Hospital, Seoul National University College of Medicine  Seoul 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