Effect of Extracorporeal Membrane Oxygenation Support on the Plasma Levels of Commonly Utilized Catecholamines

Critically ill patients requiring catecholamine infusion may require extracorporeal membrane oxygenation (ECMO) support. Initiating ECMO support may affect the circulating catecholamine levels, which directly influences the circulatory support. We measured the timed plasma levels of epinephrine, norepinephrine, and dopamine infused at a constant rate in pigs supported on the ECMO. Plasma levels of catecholamines decreased at 10 minutes after the initiation of ECMO, followed by a return to steady-state concentrations for the next 2 hours. Catecholamines levels in patients initiated on ECMO may follow similar changes.

Monitoring catecholamines levels in our swine ECMO model provide a real-life picture of changes in catecholamine levels to be observed in patients placed on ECMO. Because the catecholamine levels remain steady after a brief decrease in levels after initiating the ECMO, sustained hemodynamic support from catecholamine is expected in patients initiated on ECMO. A lack of sustained support as expected from catecholamine infusion is unlikely the result of drug adsorption to the ECMO circuit.